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Individual

DR. ASMA RAFEEQ ANSARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
159 S BLOOMINGDALE RD, BLOOMINGDALE, IL 60108-1434
(630) 529-5950
(630) 529-6286
Mailing address
159 S BLOOMINGDALE RD, BLOOMINGDALE, IL 60108-1434
(630) 529-5950
(630) 529-6286

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036122782
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036122782
MEDICAL LICENSE NUMBER
IL
01
336084349
CONTROLLED SUBSTANCE LICENSE
IL
01
35.122131
MEDICAL LICENSE
OH
01
P00906492
RAILROAD MEDICARE
IL
Enumeration date
03/27/2007
Last updated
02/04/2015
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