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General NPI Number Information
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NPI Number | 1265150544
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Entity Type | Organization
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Legal Business Name | AISHAH YANSSANEH LLC
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 155 N HARBOR DR APT 4004
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City | CHICAGO
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State | IL
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Zip | 60601-7371
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Country | US
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Telephone | 210-995-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 155 N HARBOR DR APT 4004
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City | CHICAGO
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State | IL
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Zip | 60601-7371
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Country | US
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Telephone | 210-995-2424
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | AISHAH YANSSANEH
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Credential | MD
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Telephone | 210-995-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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