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General NPI Number Information
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NPI Number | 1285941914
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Entity Type | Organization
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Legal Business Name | SHIFA MEDICAL CARE, INC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 142 E LAKE ST SUITE C
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1195
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Country | US
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Telephone | 630-351-0775
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Fax |
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Provider Business Mailing Address
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Address Line | 142 E LAKE ST SUITE C
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1195
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Country | US
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Telephone | 630-351-0775
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AFSHAN HAFIZ
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Credential | MD
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Telephone | 630-351-0775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 036104408
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036104408
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License Number State | IL
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