Healthcare Provider Details

I. General information

NPI: 1194083493
Provider Name (Legal Business Name): NEELOFAR NABI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NEELOFAR NABI M.D

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 W EDGERTON AVE
GREENFIELD WI
53220-4420
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-325-5244
  • Fax:
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6462120
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: