Provider Demographics
NPI:1992037469
Name:SEIDU-FUSEINI, HABIBA (NP)
Entity Type:Individual
Prefix:MRS
First Name:HABIBA
Middle Name:
Last Name:SEIDU-FUSEINI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HABIBA
Other - Middle Name:B
Other - Last Name:ABDALLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:722 N EMROY AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1710
Mailing Address - Country:US
Mailing Address - Phone:773-622-4313
Mailing Address - Fax:773-290-2401
Practice Address - Street 1:1629 N NATCHEZ AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-4023
Practice Address - Country:US
Practice Address - Phone:630-926-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041270674163W00000X
IL277001081363LF0000X, 363LF0000X
MI4704345051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse