Provider Demographics
NPI:1356443337
Name:RAHEEM, KAREEM (DPM)
Entity Type:Individual
Prefix:
First Name:KAREEM
Middle Name:
Last Name:RAHEEM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9933 LAWLER AVE
Mailing Address - Street 2:SUITE #225
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3703
Mailing Address - Country:US
Mailing Address - Phone:773-321-2681
Mailing Address - Fax:847-674-2113
Practice Address - Street 1:9933 LAWWLER
Practice Address - Street 2:SUITE #225
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3701
Practice Address - Country:US
Practice Address - Phone:773-321-2681
Practice Address - Fax:847-674-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL016004724213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016004724Medicaid
ILT38551Medicare ID - Type Unspecified