Provider Demographics
NPI:1972092914
Name:NADEEM, BILAL (MD)
Entity type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:NADEEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 EASTLAND DR STE 330
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-7912
Mailing Address - Country:US
Mailing Address - Phone:309-662-3311
Mailing Address - Fax:309-662-9709
Practice Address - Street 1:1505 EASTLAND DR STE 330
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-7912
Practice Address - Country:US
Practice Address - Phone:309-662-3311
Practice Address - Fax:309-662-9709
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036161616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program