Individual
KANEEZ FATIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 823-9100
Mailing address
2043 AUDUBON DR, GLENDALE HEIGHTS, IL 60139-1807
(602) 332-4905
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
11-116
IL
Other
Enumeration date
02/14/2015
Last updated
02/14/2015
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