Individual
HAZAR SHADID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
111 W MAPLE ST, CHICAGO, IL 60610-5401
(312) 608-2566
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125045523
IL
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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