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NPI Code Detail

MEDICARE: AISHA FARHEEN RAFAT

MEDICARE:   AISHA FARHEEN RAFAT
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1447934211
Entity Type Code : Individual
Provider Name (Legal Business Name) : AISHA FARHEEN RAFAT
Provider Business Mailing Address
First Line : 2401 RIVER HILLS LN
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60490-5045
Country : US
Telephone Number : 708-543-0378
Fax Number :
Provider Business Practice Location Address
First Line : 2401 RIVER HILLS LN
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60490-5045
Country : US
Telephone Number : 708-543-0378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2023
Last Update Date : 06/12/2023

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Directions to “ AISHA FARHEEN RAFAT ” Practice Location

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