Healthcare Provider Details

I. General information

NPI: 1255127387
Provider Name (Legal Business Name): NAZIA JAMALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 E BELVIDERE RD UNIT 385
GRAYSLAKE IL
60030-2026
US

IV. Provider business mailing address

1475 E BELVIDERE RD UNIT 385
GRAYSLAKE IL
60030-2026
US

V. Phone/Fax

Practice location:
  • Phone: 847-535-7157
  • Fax:
Mailing address:
  • Phone: 847-535-7157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125087713
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: