Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036126916 | IL |
N | 207Q00000X | Family Doctor | 125055499 | IL |
N | 207Q00000X | Family Doctor | 4301099529 | MI |
NPI | 1003072547 |
---|---|
Provider Name | Dr. Asad S Mehdi |
First Address | Arlington Heights, IL 60005-2349 |
Second Address | Arlington Heights, IL 60005-2349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 07/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036126916 | STATE LICENSE (01) | IL |