Healthcare Provider Details

I. General information

NPI: 1508194887
Provider Name (Legal Business Name): AYISHA JAMEEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2009
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SALT CREEK LN STE 202
HINSDALE IL
60521-2903
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-2505
  • Fax: 331-221-2719
Mailing address:
  • Phone: 847-982-4869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036152680
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: