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General NPI Number Information
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NPI Number | 1710074976
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Entity Type | Organization
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Legal Business Name | HUMAYUN S S C
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 2740 W FOSTER AVE STE 105
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City | CHICAGO
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State | IL
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Zip | 60625-3547
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Country | US
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Telephone | 773-784-2101
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Fax | 773-784-0771
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Provider Business Mailing Address
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Address Line | 2740 W FOSTER AVE STE 105
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City | CHICAGO
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State | IL
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Zip | 60625-3547
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Country | US
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Telephone | 773-784-2101
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Fax | 773-784-0771
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAMID HUMAYUN
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Credential | MD
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Telephone | 773-784-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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