Provider Demographics
NPI:1720605751
Name:NOOR, SHAHZAD
Entity Type:Individual
Prefix:
First Name:SHAHZAD
Middle Name:
Last Name:NOOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9514 OZANAM AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1059
Mailing Address - Country:US
Mailing Address - Phone:414-488-4575
Mailing Address - Fax:224-251-8319
Practice Address - Street 1:9514 OZANAM AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1059
Practice Address - Country:US
Practice Address - Phone:414-488-4575
Practice Address - Fax:224-251-8319
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide