Provider Demographics
NPI:1982957478
Name:QURESHI, MARYAH (LMFT)
Entity Type:Individual
Prefix:
First Name:MARYAH
Middle Name:
Last Name:QURESHI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6234 N PAULINA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1119
Mailing Address - Country:US
Mailing Address - Phone:312-544-0294
Mailing Address - Fax:
Practice Address - Street 1:7101 N CICERO AVE STE 203
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2144
Practice Address - Country:US
Practice Address - Phone:312-544-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2018-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000875106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist