Provider Demographics
NPI:1619957180
Name:FOAD, ABDULLAH (MD)
Entity type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:
Last Name:FOAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:IL
Mailing Address - Zip Code:61270-3042
Mailing Address - Country:US
Mailing Address - Phone:815-772-4003
Mailing Address - Fax:
Practice Address - Street 1:303 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-3042
Practice Address - Country:US
Practice Address - Phone:815-772-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31847207X00000X
IL036153493207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA31847OtherIA LICENSE
IA2152355Medicaid
IL036153493OtherIL LICENSE