Provider Demographics
NPI:1770919235
Name:FAROOQI, AMREEN (OD)
Entity type:Individual
Prefix:
First Name:AMREEN
Middle Name:
Last Name:FAROOQI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 W ROSEMONT AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1897
Mailing Address - Country:US
Mailing Address - Phone:312-399-4250
Mailing Address - Fax:
Practice Address - Street 1:833 N ROSELLE RD
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-4212
Practice Address - Country:US
Practice Address - Phone:630-351-0085
Practice Address - Fax:630-351-1530
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010697152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist