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Individual

DR. SHAHLA MAJID NYAEME

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6101 S COUNTY LINE RD, CLINIC, BURR RIDGE, IL 60527-8132
(630) 686-9000
(844) 235-2578
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036111455
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036111455
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
208341
MEDICARE GROUP NUMBER
IL
01
208342
MEDICARE GROUP NUMBER
IL
01
F100323989
GROUP MEDICARE PTAN
IL
Enumeration date
05/04/2006
Last updated
08/16/2023
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