Organization
SHAHINA H JAFRY MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER E SMITH (CREDENTIALING AGENT)
(815) 965-8505
Entity
Organization
Contact information
Practice address
6078 PALO VERDE DR, ROCKFORD, IL 61114
(815) 398-9360
Mailing address
4525 FOREST VIEW AVE, ROCKFORD, IL 61108
(815) 965-8505
(815) 965-8440
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036105570
IL
Other
Enumeration date
10/02/2006
Last updated
05/10/2016
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