Basic Information
| Provider Information | |||||||||
| NPI: | 1215183140 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSAIN | ||||||||
| FirstName: | ABRAR | ||||||||
| MiddleName: | ALI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH ST | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL CENTER OAK LAWN, LLC | ||||||||
| City: | MIAMI GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865303150 | ||||||||
| FaxNumber: | 7865303150 | ||||||||
| Practice Location | |||||||||
| Address1: | 6101 W. 95TH STREET | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL CENTER OAK LAWN, LLC | ||||||||
| City: | OAK LAWN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082610831 | ||||||||
| FaxNumber: | 3122769660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2008 | ||||||||
| LastUpdateDate: | 01/31/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 125054451 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 400280 | 01 | GROUP PTAN | OTHER |