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General NPI Number Information
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NPI Number | 1932917481
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Entity Type | Individual
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Provider Name | AHMAD M SHUAIBI PMHNP
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Gender | Male
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 11235 DISTINCTIVE DR
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City | ORLAND PARK
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State | IL
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Zip | 60467-9458
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Country | US
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Telephone | 708-479-5555
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Fax | 708-479-5055
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Provider Business Mailing Address
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Address Line | 15527 HOLLYHOCK CT
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City | ORLAND PARK
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State | IL
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Zip | 60462-5008
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209030711
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License Number State | IL
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