Individual
DR. SHAIBA ZEENATH ANSARI-ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
302 RANDALL RD STE 105, GENEVA, IL 60134-4219
(630) 232-2391
(630) 232-2472
Mailing address
302 RANDALL RD STE 105, GENEVA, IL 60134-4219
(630) 232-2391
(630) 232-2472
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036110832
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110832
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
—
01
—
206147042
MEDICARE PTAN (INDIVIDUAL)
—
Enumeration date
08/25/2006
Last updated
11/05/2019
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