Provider Demographics
NPI:1235542077
Name:JAWED, SAMEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEENA
Middle Name:
Last Name:JAWED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 RYAN PKWY
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-4530
Mailing Address - Country:US
Mailing Address - Phone:847-658-9555
Mailing Address - Fax:
Practice Address - Street 1:1345 RYAN PKWY
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-4530
Practice Address - Country:US
Practice Address - Phone:847-658-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-064893207Q00000X
IL036142450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine