Provider Demographics
NPI:1881668895
Name:AFROZ, NAYYAR (PHYSICIAN)
Entity type:Individual
Prefix:
First Name:NAYYAR
Middle Name:
Last Name:AFROZ
Suffix:
Gender:F
Credentials:PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S STATE ST
Mailing Address - Street 2:REVENUE #200, CHICAGO DEPT OF PUBLIC HEALTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-747-9443
Mailing Address - Fax:312-747-9447
Practice Address - Street 1:333 S STATE ST
Practice Address - Street 2:REVENUE #200, CHICAGO DEPT OF PUBLIC HEALTH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-747-9442
Practice Address - Fax:312-747-9447
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360991262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G89992Medicare UPIN
IL977180Medicare ID - Type Unspecified