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NPI Code Detail

MEDICARE: NOREEN KARADSHEH ATC, PES

MEDICARE:   NOREEN  KARADSHEH  ATC, PES
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
12255A2300XAthletic TrainerIL

General Provider Information

NPI Number : 1821145491
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOREEN KARADSHEH ATC, PES
Provider Business Mailing Address
First Line : 4430 N CAMPBELL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3013
Country : US
Telephone Number : 773-583-5286
Fax Number : 312-996-8349
Provider Business Practice Location Address
First Line : 839 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1530
Country : US
Telephone Number : 312-996-2043
Fax Number : 312-996-8349
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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Directions to “ NOREEN KARADSHEH ATC, PES” Practice Location

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