Provider Demographics
NPI:1558409243
Name:YASMIN, SAYEEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAYEEDA
Middle Name:
Last Name:YASMIN
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 1:17W763 14TH ST
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3721
Mailing Address - Country:US
Mailing Address - Phone:630-889-0784
Mailing Address - Fax:630-889-0784
Practice Address - Street 1:RENAISSANCE AT HILLSIDE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162
Practice Address - Country:US
Practice Address - Phone:708-544-9933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
201127Medicare ID - Type Unspecified
ILH56644Medicare UPIN