Provider Demographics
NPI:1184164006
Name:MIAN, AMARA (DO)
Entity type:Individual
Prefix:
First Name:AMARA
Middle Name:
Last Name:MIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMARA
Other - Middle Name:
Other - Last Name:SATTAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 HIDDEN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8371
Mailing Address - Country:US
Mailing Address - Phone:630-915-4673
Mailing Address - Fax:
Practice Address - Street 1:20 HIDDEN LAKE DR
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-8371
Practice Address - Country:US
Practice Address - Phone:630-915-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1567192084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology