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NPI 1831904663

NPI 1831904663 : TASSNEEM ABU-REZEQ DNP, APRN, CPNP-AC : OAK LAWN, IL

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General NPI Number Information
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    NPI Number           |    1831904663
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    Entity Type          |    Individual 
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    Provider Name        |    TASSNEEM ABU-REZEQ DNP, APRN, CPNP-AC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/10/2025
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    Last Update Date     |    06/05/2025
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Provider Practice Location Address
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    Address Line         |    4440 W 95TH ST 
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    City                 |    OAK LAWN
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    State                |    IL
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    Zip                  |    60453-2600
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    Country              |    US
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    Telephone            |    708-684-8000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4440 W 95TH ST 
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    City                 |    OAK LAWN
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    State                |    IL
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    Zip                  |    60453-2600
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    Country              |    US
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    Telephone            |    708-684-8000
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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        |    363LP0200X
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    Taxonomy Name        |    Pediatric Nurse Practitioner
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    License Number       |    209.031455
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    364SP0200X
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    Taxonomy Name        |    Pediatric Clinical Nurse Specialist
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    License Number       |    209.031455
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    License Number State |    IL
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Taxonomy #3
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    209.031455
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    License Number State |    IL
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