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General NPI Number Information
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NPI Number | 1639993538
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Entity Type | Individual
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Provider Name | AIGUL ZHOLDOSHOVA
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Gender | Female
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 912 S WOOD ST # 162-A
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City | CHICAGO
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State | IL
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Zip | 60612-4300
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Country | US
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Telephone | 312-996-6635
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Fax |
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Provider Business Mailing Address
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Address Line | 402 S HELENA AVE
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City | MT PROSPECT
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State | IL
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Zip | 60056-2854
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Country | US
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Telephone | 832-610-8126
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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 | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 125.085064
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License Number State | IL
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