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General NPI Number Information
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NPI Number | 1396181699
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Entity Type | Individual
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Provider Name | HAAJIRA CHEEMA PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 1870 S BLUE ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60608-3013
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Country | US
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Telephone | 312-738-3355
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Fax | 312-564-5252
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Provider Business Mailing Address
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Address Line | 1101 E CAMBRIA LN S
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City | LOMBARD
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State | IL
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Zip | 60148-3797
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085-004577
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License Number State | IL
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