Provider Demographics
NPI:1285022798
Name:SHIFA LIVING, LLC
Entity Type:Organization
Organization Name:SHIFA LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:CORDELIA
Authorized Official - Last Name:MILLER MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-213-1292
Mailing Address - Street 1:1136 S ELMWOOD AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2112
Mailing Address - Country:US
Mailing Address - Phone:312-213-1292
Mailing Address - Fax:708-445-2604
Practice Address - Street 1:115 N MARION ST
Practice Address - Street 2:SUITE 6
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1503
Practice Address - Country:US
Practice Address - Phone:312-213-1292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health