Provider Demographics
NPI:1205685708
Name:SHAIKH, MARIAM (PA-C)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6307 N KEDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4505
Mailing Address - Country:US
Mailing Address - Phone:847-809-1610
Mailing Address - Fax:
Practice Address - Street 1:6307 N KEDVALE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4505
Practice Address - Country:US
Practice Address - Phone:847-809-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program