Individual
AISHA IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1775 BALLARD RD, PARK RIDGE, IL 60068-1005
(847) 318-2500
(847) 318-2558
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-175475
IL
207R00000X
Internal Medicine Physician
34.017062
OH
207R00000X
Internal Medicine Physician
I550001948800
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2021
Last updated
10/06/2025
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