Provider Demographics
NPI:1083312375
Name:KURDI, KHADEEJAH NASSER
Entity Type:Individual
Prefix:
First Name:KHADEEJAH
Middle Name:NASSER
Last Name:KURDI
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 1:1979 N MILL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8472
Mailing Address - Country:US
Mailing Address - Phone:630-281-2496
Mailing Address - Fax:630-839-9138
Practice Address - Street 1:1979 N MILL ST STE 202
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8472
Practice Address - Country:US
Practice Address - Phone:630-281-2496
Practice Address - Fax:630-839-9138
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor