MEDICARE: RAABIA MUSTAFA M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	146008222	IL

General Provider Information

NPI Number	:	1376679811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAABIA MUSTAFA M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	6341 N SPRINGFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1017
Country	:	US
Telephone Number	:	872-222-6115
Fax Number	:	312-962-5673

Provider Business Practice Location Address
First Line	:	20 N WACKER DR
Second Line	:	SUITE 3830
City	:	CHICAGO
State	:	IL
Zip	:	60606-2806
Country	:	US
Telephone Number	:	872-222-6115
Fax Number	:	312-962-5673

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	02/04/2014

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Directions to “ RAABIA MUSTAFA M.S. CCC-SLP” Practice Location

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