Healthcare Provider Details

I. General information

NPI: 1710393210
Provider Name (Legal Business Name): NASEEM FATIMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 W NORTH AVE STE 101
ELMHURST IL
60126-2100
US

IV. Provider business mailing address

533 W NORTH AVE STE 101
ELMHURST IL
60126-2100
US

V. Phone/Fax

Practice location:
  • Phone: 312-738-3355
  • Fax: 312-564-5252
Mailing address:
  • Phone: 312-738-3355
  • Fax: 312-564-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.173043
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: