Individual
ASAD KIZILBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4646 N MARINE DR, MEDICAL EDUCATION DEPT, CHICAGO, IL 60640-5759
(773) 564-5225
Mailing address
4300 W LAKE AVE, 208-B, GLENVIEW, IL 60026-1474
(847) 510-5734
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01072237A
IN
207R00000X
Internal Medicine Physician
29446
OR
208M00000X
Hospitalist Physician
01072237A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201164440
—
IN
Enumeration date
01/28/2009
Last updated
10/31/2024
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