MEDICARE: MARIAM QURESHI

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
1	213E00000X	Podiatrist	07001468A	IN

General Provider Information

NPI Number	:	1003499138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAM QURESHI

Provider Business Mailing Address
First Line	:	4646 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5759
Country	:	US
Telephone Number	:	773-564-5738
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5759
Country	:	US
Telephone Number	:	773-564-5738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	04/09/2026

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Directions to “ MARIAM QURESHI ” Practice Location

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