Qayyum, Imad
Qayyum, Imad is an individual health care provider with primary practice located at 12255 S 80Th Ave , Palos Heights IL 60463-1270. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Qayyum, Imad can be contacted via phone (708) 923-4400.Contact Information
Primary practice address
12255 S 80Th Ave
Palos Heights IL 60463-1270
Phone: (708) 923-4400
Fax: (708) 923-4421
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036.143807 | Illinois |
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 036.143807 | Illinois |
Profile Details
| NPI number | 1760776173 |
|---|---|
| LBN Legal business name | Qayyum, Imad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2011 |
| Last updated | Jan 23rd, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760776173 | NPPES |
| Illinois | MEDICAID | 036143807 |
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