Healthcare Provider Details

I. General information

NPI: 1770679920
Provider Name (Legal Business Name): SABIHA GAFOOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHICAGO DEPARTMENT OF PUBLIC HEALTH 333 S STATE STREET REVENUE #200
CHICAGO IL
60604
US

IV. Provider business mailing address

CHICAGO DEPARTMENT OF PUBLIC HEALTH 333 S STATE STREET REVENUE #200
CHICAGO IL
60604
US

V. Phone/Fax

Practice location:
  • Phone: 312-747-9443
  • Fax: 312-747-9447
Mailing address:
  • Phone: 312-747-9443
  • Fax: 312-747-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036071365
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-071365
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number036-071365
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: