Provider Demographics
NPI:1821145491
Name:KARADSHEH, NOREEN (ATC, PES)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:KARADSHEH
Suffix:
Gender:F
Credentials:ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3013
Mailing Address - Country:US
Mailing Address - Phone:773-583-5286
Mailing Address - Fax:312-996-8349
Practice Address - Street 1:839 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1530
Practice Address - Country:US
Practice Address - Phone:312-996-2043
Practice Address - Fax:312-996-8349
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer