MEDICARE: INTERNAL AUTHENTICITY

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1528930856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL AUTHENTICITY

Provider Business Mailing Address
First Line	:	6100 N SEELEY AVE APT 2A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4390
Country	:	US
Telephone Number	:	872-303-5085
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 N SEELEY AVE APT 2A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4390
Country	:	US
Telephone Number	:	872-303-5085
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICAL
Name	:	FADUMA MOHAMED SHEIKH-ABDI
Credential	:	LCPC
Telephone Number	:	872-303-5085

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

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