Provider Demographics
NPI:1467711689
Name:ALI, FATIMA HADI (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:HADI
Last Name:ALI
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 1:152 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2821
Mailing Address - Country:US
Mailing Address - Phone:630-833-9621
Mailing Address - Fax:
Practice Address - Street 1:152 N ADDISON AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-833-9621
Practice Address - Fax:630-833-9465
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144336207W00000X, 207W00000X
GA75592207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program