MEDICARE: SHAFEEN FATIMA

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	1041C0700X	Clinical Social Worker		IL
2	104100000X	Social Worker		IL

General Provider Information

NPI Number	:	1851194336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAFEEN FATIMA

Provider Business Mailing Address
First Line	:	600 LAKEWOOD FARMS DR
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60490-3162
Country	:	US
Telephone Number	:	630-935-9313
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 W JACKSON ST
Second Line	:
City	:	JOLIET
State	:	IL
Zip	:	60432-1729
Country	:	US
Telephone Number	:	630-935-9313
Fax Number	:

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

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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Directions to “ SHAFEEN FATIMA ” Practice Location

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