Individual
HABEEBA SIRAJUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 MEDICAL CENTER DR, MONTICELLO, IL 61856-2116
(217) 762-2518
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801-2527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036145460
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2015
Last updated
05/26/2022
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