Provider Demographics
NPI:1881685071
Name:HUSSAIN, MEH JABEEN (MD)
Entity Type:Individual
Prefix:
First Name:MEH JABEEN
Middle Name:
Last Name:HUSSAIN
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 1:902 S RANDALL RD
Mailing Address - Street 2:C187
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1554
Mailing Address - Country:US
Mailing Address - Phone:630-835-9954
Mailing Address - Fax:630-377-3705
Practice Address - Street 1:902 S RANDALL RD
Practice Address - Street 2:C187
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1554
Practice Address - Country:US
Practice Address - Phone:630-835-9954
Practice Address - Fax:630-377-3705
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360989902084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098990Medicaid
IL036098990Medicaid
ILK36867Medicare UPIN