Individual
ASAD JAMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 N JACKSON ST, MORRISON, IL 61270-3042
(815) 772-4003
Mailing address
303 N JACKSON ST, MORRISON, IL 61270-3042
(815) 772-4003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-114596
IL
207Q00000X
Family Medicine Physician
Primary
036114596
IL
208M00000X
Hospitalist Physician
036114596
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114596
—
IL
01
—
553180
MEDICARE GROUP
IL
01
—
834340
MEDICARE GROUP #
IL
01
—
F400220687
MEDICARE PTAN
IL
Enumeration date
06/14/2006
Last updated
01/24/2025
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