Individual provider Active NPI

Syed Muhammad Qambar Raza

  • Student in an Organized Health Care Education/Training Program
  • Willowbrook, IL
National Provider Identifier
1417709015
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6237 Bentley Ave
Willowbrook, IL 60527-1962
Phone
(630) 642-3953
NPI assigned
Apr 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6237 Bentley Ave
Willowbrook, IL 60527-1962

Mailing address

6237 Bentley Ave
Willowbrook, IL 60527-1962
Phone (630) 642-3953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1417709015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6237 BENTLEY AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271962",
            "telephone_number": "630-642-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6237 BENTLEY AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271962",
            "telephone_number": "630-642-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZA",
        "first_name": "SYED MUHAMMAD QAMBAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.