Mir, Ayezah

Mir, Ayezah is an individual health care provider with primary practice located at 700 W Jefferson St , Shorewood IL 60404-7608. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mir, Ayezah can be contacted via phone (815) 514-2040.

Contact Information

Primary practice address
700 W Jefferson St Shorewood IL 60404-7608
Fax: (815) 741-2860
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-112854 Illinois

Profile Details

NPI number 1740227388
LBN Legal business name Mir, Ayezah
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Aug 16th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740227388 NPPES
Illinois MEDICAID 036112854

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