Healthcare Provider Details
I. General information
NPI: 1659118628
Provider Name (Legal Business Name): ARUB QURESHI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2024
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8525 S HARLEM AVE
BURBANK IL
60459-2293
US
IV. Provider business mailing address
8525 S HARLEM AVE
BURBANK IL
60459-2293
US
V. Phone/Fax
- Phone: 708-599-0050
- Fax:
- Phone: 888-899-0816
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 046011860 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: