Individual
MUSEDIQ ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2875 W 19TH ST, CHICAGO, IL 60623-3596
(773) 657-1554
Mailing address
2875 W 19TH ST, CHICAGO, IL 60623-3596
(773) 657-1554
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209030937
IL
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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