MEDICARE: SABEENA GUL FNP

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	363L00000X	Nurse Practitioner	209.024939	IL

General Provider Information

NPI Number	:	1093465932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABEENA GUL FNP

Provider Business Mailing Address
First Line	:	9406 GREENWOOD DR
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-3944
Country	:	US
Telephone Number	:	630-666-3864
Fax Number	:

Provider Business Practice Location Address
First Line	:	6352 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1213
Country	:	US
Telephone Number	:	872-208-3095
Fax Number	:

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

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	03/24/2022

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