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General NPI Number Information
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NPI Number | 1750844726
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Entity Type | Individual
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Provider Name | SHEREEN AHMED FAROOQ DO
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Gender | Female
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 6345 W 79TH ST
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City | BURBANK
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State | IL
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Zip | 60459-1133
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Country | US
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Telephone | 708-499-1545
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Fax |
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 58030963
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-167552
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License Number State | IL
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