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General NPI Number Information
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NPI Number | 1194542449
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Entity Type | Individual
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Provider Name | NADA BANAFA
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Gender | Female
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Dates
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Enumeration Date | 09/26/2024
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 5645 W ADDISON ST
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City | CHICAGO
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State | IL
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Zip | 60634-4403
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Country | US
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Telephone | 773-794-7601
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Fax |
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Provider Business Mailing Address
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Address Line | 5531 S PARK AVE
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City | HINSDALE
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State | IL
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Zip | 60521-5061
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Country | US
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Telephone | 682-206-1837
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209.030663
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License Number State | IL
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