Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071007673 | IL |
Y | 103TC0700X | Clinical Psychologist | 071007673 | IL |
NPI | 1003040668 |
---|---|
Provider Name | Dr. Aisha Kazi |
First Address | Chicago, IL 60611-2926 |
Second Address | Chicago, IL 60611-2926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 16/07/2012 |