Healthcare Provider Details

I. General information

NPI: 1831582055
Provider Name (Legal Business Name): FATEMA UKANI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 ARTESIAN RD STE 144
NAPERVILLE IL
60564-4876
US

IV. Provider business mailing address

2960 ARTESIAN RD STE 144
NAPERVILLE IL
60564-4876
US

V. Phone/Fax

Practice location:
  • Phone: 630-687-9206
  • Fax:
Mailing address:
  • Phone: 630-687-9206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMU7403051
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number385004276
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085005396
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: