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General NPI Number Information
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NPI Number | 1548676067
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Entity Type | Organization
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Legal Business Name | FYEQA SHEIKH LLC
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 4050 N LINCOLN AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60618-3067
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Country | US
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Telephone | 773-678-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 W BERWYN AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60625-4759
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Country | US
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Telephone | 773-678-4404
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. FYEQA SHEIKH
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Credential | PSY.D.
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Telephone | 773-678-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071008768
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License Number State | IL
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