Provider Demographics
NPI:1902072812
Name:RIAZ A. AKHTAR
Entity Type:Organization
Organization Name:RIAZ A. AKHTAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RIAZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACC
Authorized Official - Phone:1708-386-8118
Mailing Address - Street 1:910 S GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1904
Mailing Address - Country:US
Mailing Address - Phone:170-838-6811
Mailing Address - Fax:163-060-0467
Practice Address - Street 1:1 SOUTH 085 SUMMIT AVENUE
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3978
Practice Address - Country:US
Practice Address - Phone:630-629-6700
Practice Address - Fax:630-600-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL000900130OtherBCBS
IL036047761Medicaid
IL060016608OtherRAILROAD
IL036047761Medicaid
IL222050Medicare PIN