MEDICARE: AMJAD NASER

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	374700000X	Technician

General Provider Information

NPI Number	:	1720721822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMJAD NASER

Provider Business Mailing Address
First Line	:	6112 W LAWRENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2940
Country	:	US
Telephone Number	:	224-406-1045
Fax Number	:

Provider Business Practice Location Address
First Line	:	5362 W LAWRENCE AVE STE CW
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-3659
Country	:	US
Telephone Number	:	224-406-1045
Fax Number	:

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

Provider Enumeration Date	:	04/16/2022
Last Update Date	:	04/16/2022

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Directions to “ AMJAD NASER ” Practice Location

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