Provider Demographics
NPI:1336375765
Name:MUZAFFAR, NOSHEEN (MD)
Entity Type:Individual
Prefix:
First Name:NOSHEEN
Middle Name:
Last Name:MUZAFFAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 GIDDINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6127 GREEN BAY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2946
Practice Address - Country:US
Practice Address - Phone:630-786-6465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57637 - 20207Q00000X, 207R00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology