Provider Demographics
NPI:1548271380
Name:IMAM, JAVED (MD)
Entity type:Individual
Prefix:DR
First Name:JAVED
Middle Name:
Last Name:IMAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:WEST TOWER SUITE 607
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-475-6063
Mailing Address - Fax:847-475-6065
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:WEST TOWER SUITE 607
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-475-6063
Practice Address - Fax:847-475-6065
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036084937207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL84313Medicare UPIN