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Individual

DR. ABDUL GHANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
17850 KEDZIE AVE STE 3250, HAZEL CREST, IL 60429-2082
(708) 799-8700
(708) 957-1830
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-6458
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-093993
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036093993
IL
01
060071274
PALMETTO GBA INDIVIDUAL #
IL
01
21622931
BCBS GROUP #
IL
01
526200
MEDICARE GROUP #
IL
01
CI8250
PALMETTO GROUP #
IL
Enumeration date
08/26/2005
Last updated
04/03/2023
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