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NPI Code Detail

MEDICARE: NIVEEN M ATIEH M.H.S.

MEDICARE: NIVEEN M ATIEH M.H.S.
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
1235Z00000XSpeech-Language Pathologist242.004121IL

General Provider Information

NPI Number : 1568913606
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIVEEN M ATIEH M.H.S.
Provider Business Mailing Address
First Line : 18469 BELLAGIO CIRCLE
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14711 S RAVINIA AVE
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3100
Country : US
Telephone Number : 708-226-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2016
Last Update Date : 10/24/2016

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Directions to “ NIVEEN M ATIEH M.H.S.” Practice Location

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