Individual
AYESHA FATIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
714 N TAMARAC BLVD, ADDISON, IL 60101-1694
(773) 563-5572
Mailing address
714 N TAMARAC BLVD, ADDISON, IL 60101-1694
(773) 563-5572
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011745
IL
Other
Enumeration date
02/14/2025
Last updated
12/30/2025
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