Basic Information
| Provider Information | |||||||||
| NPI: | 1356393557 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ASAD ZAMAN MD SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O BOX 1033 | ||||||||
| Address2: | |||||||||
| City: | YORKVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605601033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303852594 | ||||||||
| FaxNumber: | 6303852778 | ||||||||
| Practice Location | |||||||||
| Address1: | 6700 167TH ST | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | TINLEY PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604772859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084293700 | ||||||||
| FaxNumber: | 7084294460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2020 | ||||||||
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| AuthorizedOfficialLastName: | ZAMAN | ||||||||
| AuthorizedOfficialFirstName: | ASAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 7084293700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 208000000X | IL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01622760 | 01 | IL | BLUE SHIELD NUMBER | OTHER |