Provider Demographics
NPI:1982691259
Name:BOKHARI, SYED SAQIB ABRAR (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:SAQIB ABRAR
Last Name:BOKHARI
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 1:1051 ESSINGTON RD
Mailing Address - Street 2:SUITE 230A
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2892
Mailing Address - Country:US
Mailing Address - Phone:815-730-0202
Mailing Address - Fax:
Practice Address - Street 1:1051 ESSINGTON RD
Practice Address - Street 2:SUITE 230A
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2892
Practice Address - Country:US
Practice Address - Phone:815-730-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118697208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H22484Medicare UPIN
ILIL2735001Medicare PIN