Individual
SAFDAR ALI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2222 W DIVISION ST, #220, CHICAGO, IL 60622
(773) 384-1100
(773) 384-6176
Mailing address
PO BOX 5015, OAK BROOK, IL 60522-5015
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630147
BCBS
IL
01
—
DC8739
RAIL ROAD MEDICARE
—
01
—
P00195462
RAIL ROAD MEDICARE
—
Enumeration date
05/23/2006
Last updated
07/08/2007
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