Basic Information
| Provider Information | |||||||||
| NPI: | 1568913606 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATIEH | ||||||||
| FirstName: | NIVEEN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.H.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18469 BELLAGIO CIRCLE | ||||||||
| Address2: | |||||||||
| City: | TINLEY PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60477 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 14711 S RAVINIA AVE | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604623100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082269200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2016 | ||||||||
| LastUpdateDate: | 10/24/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 242.004121 | IL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.