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NPI Code Detail

MEDICARE: DR. SHAFFIQ YUSUF MD

MEDICARE: DR. SHAFFIQ YUSUF 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 Physician036177934IL

General Provider Information

NPI Number : 1073216545
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAFFIQ YUSUF MD
Provider Business Mailing Address
First Line : 7702 N ALPINE RD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-3107
Country : US
Telephone Number : 815-971-3310
Fax Number :
Provider Business Practice Location Address
First Line : 7702 N ALPINE RD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-3107
Country : US
Telephone Number : 815-971-3310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 05/14/2026

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