Provider Demographics
NPI:1285245100
Name:FATMA, UZRA
Entity type:Individual
Prefix:
First Name:UZRA
Middle Name:
Last Name:FATMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17101 ARBOR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5478
Mailing Address - Country:US
Mailing Address - Phone:630-550-1540
Mailing Address - Fax:630-401-8648
Practice Address - Street 1:2003 MONTGOMERY RD STE 108109
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-9078
Practice Address - Country:US
Practice Address - Phone:630-401-8286
Practice Address - Fax:630-401-8648
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric