Healthcare Provider Details

I. General information

NPI: 1245379320
Provider Name (Legal Business Name): RAFIYA HAMEEDUDDIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAFIYA KHAN DO

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE. IM HOSPITALISTS STE 4210
EVANSTON IL
60201
US

IV. Provider business mailing address

2650 RIDGE AVE. IM HOSPITALISTS STE 4210
EVANSTON IL
60201
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-1010
  • Fax: 847-733-5108
Mailing address:
  • Phone: 847-570-1010
  • Fax: 847-733-5108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036091808
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036091808
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: