Basic Information
| Provider Information | |||||||||
| NPI: | 1629647169 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | FAROOQUI | ||||||||
| FirstName: | ABDULLAH | ||||||||
| MiddleName: | ZEESHAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2413 MANCHESTER CT APT D | ||||||||
| Address2: | |||||||||
| City: | WOODRIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605172067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302903606 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7531 S STONY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606493993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7739477500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2021 | ||||||||
| LastUpdateDate: | 06/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 125.078531 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.