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General NPI Number Information
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NPI Number | 1487932323
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Entity Type | Individual
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Provider Name | SADIA AFREEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 8617 S COTTAGE GROVE AVE
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City | CHICAGO
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State | IL
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Zip | 60619-6107
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Country | US
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Telephone | 773-651-7106
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Fax |
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Provider Business Mailing Address
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Address Line | 1629 S MICHIGAN AVE APT 305
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City | VILLA PARK
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State | IL
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Zip | 60181-4101
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Country | US
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Telephone | 408-712-8922
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010532
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License Number State | IL
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