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Individual

SHAHINA H JAFRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
526 W. STATE STREET, ROCKFORD, IL 61101-1214
(815) 968-9300
(815) 968-5314
Mailing address
526 W. STATE STREET, PO BOX 813, ROCKFORD, IL 61101-1214
(815) 968-9300
(815) 968-5314

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036105570
IL
2084P0800X
Psychiatry Physician
Primary
36105570
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036105570
IL
Enumeration date
02/06/2006
Last updated
06/29/2011
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