NPIMap

Individual provider Active NPI

Anwarul Haque, MD

  • Pediatric Critical Care Medicine Physician
  • Peoria, IL
National Provider Identifier
1992770291
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Practice address
Dept of Pediatric Critical Care
530 NE Glen Oak
Peoria, IL 61637-0001
Phone
(309) 655-2250
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X IL Primary

Addresses

Primary practice location

Dept of Pediatric Critical Care
530 NE Glen Oak
Peoria, IL 61637-0001

Mailing address

1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-8503

Other identifiers 2

IdentifierTypeStateIssuer
07215036OtherILBCBS
IL01AAOtherILJOHN DEERE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036111538ILMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
Aims Physicians and Surgeons Past Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Pediatric Critical Care Medicine Past Accepting new patients
University of Illinois Past Accepting new patients
Arizona Institute of Medicine and Surgery Past Accepting new patients
University of Illinois Past Accepting new patients

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992770291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ILLINI DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052576",
            "telephone_number": "309-671-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF PEDIATRIC CRITICAL CARE",
            "address_2": "530 NE GLEN OAK",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "ANWARUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07215036",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL01AA",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.