Provider Demographics
NPI:1265938146
Name:SYED, ADEEB ULLAH (DO)
Entity type:Individual
Prefix:
First Name:ADEEB
Middle Name:ULLAH
Last Name:SYED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18W140 BUTTERFIELD RD STE 1020
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4851
Mailing Address - Country:US
Mailing Address - Phone:630-320-6871
Mailing Address - Fax:630-385-0026
Practice Address - Street 1:18W140 BUTTERFIELD RD STE 1020
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4851
Practice Address - Country:US
Practice Address - Phone:630-320-6871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036161037208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036161037Medicaid