Healthcare Provider Details
I. General information
NPI: 1083375513
Provider Name (Legal Business Name): NADEEM ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2022
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6430 N BELL AVE APT GS
CHICAGO IL
60645-5193
US
IV. Provider business mailing address
6430 N BELL AVE APT GS
CHICAGO IL
60645-5193
US
V. Phone/Fax
- Phone: 872-235-2723
- Fax:
- Phone: 872-235-2723
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246RM2200X |
| Taxonomy | Medical Laboratory Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YOUSUF
AHMED
Title or Position: PRESIDENT
Credential:
Phone: 872-235-2723