1477084929 NPI number — MR. SYED HAMZA KAZMI

Table of content: MR. SYED HAMZA KAZMI (NPI 1477084929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477084929 NPI number — MR. SYED HAMZA KAZMI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAZMI
Provider First Name:
SYED
Provider Middle Name:
HAMZA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477084929
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1775 DEMPSTER STREET, 2 SOUTH -MAILBOX 54
Provider Second Line Business Mailing Address:
PARK RIDGE, IL 60068
Provider Business Mailing Address City Name:
PARK RIDGE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-723-4313
Provider Business Mailing Address Fax Number:
847-723-2338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1775 DEMPSTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARK RIDGE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60068-1143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-723-4313
Provider Business Practice Location Address Fax Number:
847-723-2338
Provider Enumeration Date:
03/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 29594 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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