Individual
AZADEH FATEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
2858 W DIVERSEY AVE, CHICAGO, IL 60647-1871
(312) 374-6621
Mailing address
2858 W DIVERSEY AVE, CHICAGO, IL 60647-1871
(573) 201-7742
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/01/2013
Last updated
09/02/2021
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