Provider Demographics
NPI:1134179450
Name:ANWAR, ASIF (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:
Last Name:ANWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 7132960
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-0001
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:330 MADISON ST STE 103
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6572
Practice Address - Country:US
Practice Address - Phone:630-871-6699
Practice Address - Fax:630-348-3323
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119110207RC0200X, 207RP1001X, 207RC0200X
FLME129527207RP1001X, 207RP1001X
WV30997207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQO564OtherMEDICARE HF
FL117691800Medicaid
IL20-4872623Medicaid
FL020596100Medicaid
FL020596100Medicaid
WI134179450Medicaid