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General NPI Number Information
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NPI Number | 1376679811
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Entity Type | Individual
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Provider Name | RAABIA MUSTAFA M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 20 N WACKER DR SUITE 3830
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City | CHICAGO
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State | IL
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Zip | 60606-2806
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Country | US
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Telephone | 872-222-6115
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Fax | 312-962-5673
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Provider Business Mailing Address
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Address Line | 6341 N SPRINGFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60659-1017
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Country | US
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Telephone | 872-222-6115
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Fax | 312-962-5673
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146008222
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License Number State | IL
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