Provider Demographics
NPI:1396205308
Name:YOUSIF, SHEERAZ
Entity Type:Individual
Prefix:
First Name:SHEERAZ
Middle Name:
Last Name:YOUSIF
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 1:12710 W WAVELAND CT
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-4518
Mailing Address - Country:US
Mailing Address - Phone:708-341-3446
Mailing Address - Fax:888-412-6023
Practice Address - Street 1:12710 W WAVELAND CT
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-4518
Practice Address - Country:US
Practice Address - Phone:708-341-3446
Practice Address - Fax:888-412-6023
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily