Provider Demographics
NPI:1023645553
Name:SADIQ, MUHIBB (DPT)
Entity type:Individual
Prefix:
First Name:MUHIBB
Middle Name:
Last Name:SADIQ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5736 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3473
Mailing Address - Country:US
Mailing Address - Phone:847-917-3928
Mailing Address - Fax:
Practice Address - Street 1:193 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3309
Practice Address - Country:US
Practice Address - Phone:312-970-9404
Practice Address - Fax:949-655-5898
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0243072251X0800X
IL0700243072251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic