Individual
DR. MUNAVVAR IZHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ME
Contact information
Practice address
7531 S STONY ISLAND AVE, SUITE 158 & 160, CHICAGO, IL 60649-3954
(773) 947-7841
(773) 493-1430
Mailing address
855 MADISON ST, OAK PARK, IL 60302-4420
(708) 492-4077
(708) 386-2839
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036100758
IL
207RN0300X
Nephrology Physician
Primary
036100758
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100758
—
IL
01
—
1616108
BCBS
IL
01
—
P00471286
RAILROAD NUMBER
IL
Enumeration date
04/14/2006
Last updated
07/26/2013
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