Provider Demographics
NPI:1235000753
Name:KARIM, SAMIULLAH
Entity type:Individual
Prefix:
First Name:SAMIULLAH
Middle Name:
Last Name:KARIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 GREGORY AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-7534
Mailing Address - Country:US
Mailing Address - Phone:630-457-8029
Mailing Address - Fax:
Practice Address - Street 1:559 GREGORY AVE APT 2D
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-7534
Practice Address - Country:US
Practice Address - Phone:630-457-8029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILK65078098221172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty