Provider Demographics
NPI:1407854201
Name:NAAMAN, DEBORAH (DO)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:NAAMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-3357
Mailing Address - Country:US
Mailing Address - Phone:630-935-7570
Mailing Address - Fax:
Practice Address - Street 1:1374 IRIS AVE
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-3357
Practice Address - Country:US
Practice Address - Phone:630-935-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082133207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036082133Medicaid
IL04532206OtherBLUE CROSS BLUE SHIELD
ILK10461Medicare PIN
ILE94424Medicare UPIN