Sherazuddin Qureshi
Surgeon Vascular Surgeon
20060 Governors Dr
Olympia Fields
, Illinois 60461
Sherazuddin Qureshi
Surgeon Vascular Surgeon
20060 Governors Dr
Olympia Fields
, Illinois 60461
(617) 372-0304
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About
Features
Specialties
- Surgeon
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Sherazuddin Qureshi
- 845 S Catherine Ave
- La Grange, IL
- Zip : 60525-2830
- Phone : (617) 372-0304
Second Address
- Sherazuddin Qureshi
- 20060 Governors Dr
- Olympia Fields, IL
- Zip : 60461
- Phone : (815) 824-4406
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 036141475 | IL |
| N | 208600000X | Surgeon | 036141475 | IL |
| Y | 2086S0129X | Vascular Surgeon | 036141475 | IL |
National Provider Identifier
| NPI | 1043453806 |
|---|---|
| Provider Name | Sherazuddin Qureshi |
| First Address | La Grange, IL 60525-2830 |
| Second Address | Olympia Fields, IL 60461 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/04/2009 |
| Last Update Date | 06/05/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036141475 | STATE LICENSE (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.