MEDICARE: NADIA HAQUE DPT

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	2251X0800X	Orthopedic Physical Therapist	070016849	IL
2	225100000X	Physical Therapist	070016849	IL

General Provider Information

NPI Number	:	1962791327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA HAQUE DPT

Provider Business Mailing Address
First Line	:	205 W WACKER DR
Second Line	:	SUITE 1020
City	:	CHICAGO
State	:	IL
Zip	:	60606-1216
Country	:	US
Telephone Number	:	312-640-0329
Fax Number	:

Provider Business Practice Location Address
First Line	:	8658 S COTTAGE GROVE AVE
Second Line	:	UNITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60619-6186
Country	:	US
Telephone Number	:	773-723-1270
Fax Number	:

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

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	10/15/2012

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Directions to “ NADIA HAQUE DPT” Practice Location

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