Provider Demographics
NPI:1255532784
Name:QURESHI, JAVERIA SHAHEEN (MD MPH)
Entity type:Individual
Prefix:DR
First Name:JAVERIA
Middle Name:SHAHEEN
Last Name:QURESHI
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 KACIE CT
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3299
Mailing Address - Country:US
Mailing Address - Phone:630-460-7374
Mailing Address - Fax:
Practice Address - Street 1:208 KACIE CT
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-3299
Practice Address - Country:US
Practice Address - Phone:630-297-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01646208600000X
IDMC-0301208600000X
KS04-42535208600000X
WA61006642208600000X
WY12457C208600000X
IAMD-46586208600000X
IL036.138255208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCO136AOtherMEDICARE PTAN