Provider Demographics
NPI:1023658416
Name:CUMMINGS, HANEEFAH MARYAM (CF-SLP)
Entity type:Individual
Prefix:
First Name:HANEEFAH
Middle Name:MARYAM
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8102 SAWMILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4918
Mailing Address - Country:US
Mailing Address - Phone:708-582-9736
Mailing Address - Fax:
Practice Address - Street 1:7360 N LINCOLN AVE STE 110
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1705
Practice Address - Country:US
Practice Address - Phone:855-855-2712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.005625207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology