Individual
AYESHA B QADIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3132 OLD JACKSONVILLE RD STE 200, SPRINGFIELD, IL 62704-7401
(217) 862-0800
(217) 862-0871
Mailing address
3132 OLD JACKSONVILLE RD STE 200, SPRINGFIELD, IL 62704-7401
(217) 862-0800
(217) 862-0871
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036168472
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336125143
CS LICENSE
IL
Enumeration date
04/29/2014
Last updated
04/09/2024
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