Provider Demographics
NPI:1538576194
Name:YASMEEN, NAHEED
Entity type:Individual
Prefix:
First Name:NAHEED
Middle Name:
Last Name:YASMEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 WASHINGTON ST
Mailing Address - Street 2:#203
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5305
Mailing Address - Country:US
Mailing Address - Phone:847-855-7000
Mailing Address - Fax:847-855-6080
Practice Address - Street 1:6121 WASHINGTON ST
Practice Address - Street 2:#203
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5305
Practice Address - Country:US
Practice Address - Phone:847-855-7000
Practice Address - Fax:847-855-6080
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist