Individual
ANWARUL HAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DEPT OF PEDIATRIC CRITICAL CARE, 530 NE GLEN OAK, PEORIA, IL 61637-0001
(309) 655-2250
Mailing address
1 ILLINI DR, PEORIA, IL 61605-2576
(309) 671-8503
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07215036
BCBS
IL
01
—
IL01AA
JOHN DEERE
IL
Enumeration date
02/21/2006
Last updated
07/09/2007
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