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General NPI Number Information
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NPI Number | 1023468840
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Entity Type | Individual
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Provider Name | YUSRA MOURSY
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Gender | Female
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 1029 E 130TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-6908
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Country | US
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Telephone | 773-995-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N LAKE SHORE DR
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City | CHICAGO
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State | IL
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Zip | 60611-5061
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME143621
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 008300
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.158661
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License Number State | IL
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