Healthcare Provider Details

I. General information

NPI: 1124107180
Provider Name (Legal Business Name): MAYSOON AL NAQEEB MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 EAST 53RD STREET SUITE 716
CHICAGO IL
60615
US

IV. Provider business mailing address

1525 EAST 53RD STREET SUITE 716
CHICAGO IL
60615
US

V. Phone/Fax

Practice location:
  • Phone: 773-288-4411
  • Fax: 773-288-2797
Mailing address:
  • Phone: 773-288-4411
  • Fax: 773-288-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAYSOON AL NAQEEB
Title or Position: OWNER
Credential: MD
Phone: 773-288-4411