Individual
ABIDA IRSHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-0000
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-0353
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-130257
IL
208M00000X
Hospitalist Physician
Primary
036130257
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL5686074
MEDICARE PTAN
IL
Enumeration date
04/30/2009
Last updated
03/15/2021
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