Healthcare Provider Details

I. General information

NPI: 1114961356
Provider Name (Legal Business Name): AL-SHAFA HEALTH CARE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 WEST ARTHUR AVENUE APT # 1A
CHICAGO IL
60645
US

IV. Provider business mailing address

2022 WEST ARTHUR AVENUE APT # 1A
CHICAGO IL
60645
US

V. Phone/Fax

Practice location:
  • Phone: 773-262-3657
  • Fax: 773-262-3657
Mailing address:
  • Phone: 773-262-3657
  • Fax: 773-262-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AHMAD NAEEM
Title or Position: PRESIDENT
Credential: PHYSICAL THERAPIST
Phone: 773-262-3657