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Individual

MS. ATEFEH DJAVID

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
367 W LOCUST ST UNIT 509, CHICAGO, IL 60610-3041
(224) 848-2548

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
209020285
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209020285
IL

Other

Enumeration date
01/07/2020
Last updated
01/07/2020
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