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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760776173 NPPES
Illinois MEDICAID 036143807

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