Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209016418 | IL |
NPI | 1003334418 |
---|---|
Provider Name | Mrs. Uzma Shamsi |
First Address | West Chicago, IL 60185-4818 |
Second Address | West Chicago, IL 60185-4818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2017 |
Last Update Date | 05/12/2017 |