Healthcare Provider Details

I. General information

NPI: 1437938743
Provider Name (Legal Business Name): NASIMUS SAHAR ASHRAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LAKE ST
ROSELLE IL
60172-3544
US

IV. Provider business mailing address

490 W LAKE ST
ROSELLE IL
60172-3583
US

V. Phone/Fax

Practice location:
  • Phone: 630-550-7252
  • Fax:
Mailing address:
  • Phone: 630-550-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041582938
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.033501
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: