Basic Information
| Provider Information | |||||||||
| NPI: | 1164402335 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROHAIL | ||||||||
| FirstName: | HUMA | ||||||||
| MiddleName: | Q. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 W 22ND ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605231563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305175120 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 329 REMINGTON BLVD STE 140 | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604405812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306855699 | ||||||||
| FaxNumber: | 6302269750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2006 | ||||||||
| LastUpdateDate: | 04/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 036090858 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 036090858 | 05 | IL | MEDICAID |