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NPI Code Detail

MEDICARE: DR. AYESHA HUSSAIN MD

MEDICARE: DR. AYESHA HUSSAIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036.117664IL

General Provider Information

NPI Number : 1003025438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AYESHA HUSSAIN MD
Provider Business Mailing Address
First Line : 2424 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-4100
Country : US
Telephone Number : 773-761-0300
Fax Number :
Provider Business Practice Location Address
First Line : 2424 W. PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-4100
Country : US
Telephone Number : 773-761-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 01/31/2022

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