Provider Demographics
NPI:1609525773
Name:FEROZE, ASRA (MD)
Entity Type:Individual
Prefix:
First Name:ASRA
Middle Name:
Last Name:FEROZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASRA
Other - Middle Name:
Other - Last Name:NAEEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3342
Mailing Address - Country:US
Mailing Address - Phone:708-654-4804
Mailing Address - Fax:
Practice Address - Street 1:630 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3342
Practice Address - Country:US
Practice Address - Phone:708-654-4804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program