Provider Demographics
NPI:1790157600
Name:WARISI, SAMEERA (MS)
Entity Type:Individual
Prefix:
First Name:SAMEERA
Middle Name:
Last Name:WARISI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 N OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-4836
Mailing Address - Country:US
Mailing Address - Phone:773-793-4846
Mailing Address - Fax:
Practice Address - Street 1:4412 N OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-4836
Practice Address - Country:US
Practice Address - Phone:773-793-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist