MEDICARE: NAHEED YASMEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019029942	IL

General Provider Information

NPI Number	:	1538576194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHEED YASMEEN

Provider Business Mailing Address
First Line	:	6121 WASHINGTON ST
Second Line	:	#203
City	:	GURNEE
State	:	IL
Zip	:	60031-5305
Country	:	US
Telephone Number	:	847-855-7000
Fax Number	:	847-855-6080

Provider Business Practice Location Address
First Line	:	6121 WASHINGTON ST
Second Line	:	#203
City	:	GURNEE
State	:	IL
Zip	:	60031-5305
Country	:	US
Telephone Number	:	847-855-7000
Fax Number	:	847-855-6080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	07/16/2014

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Directions to “ NAHEED YASMEEN ” Practice Location

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