Provider Demographics
NPI:1316058209
Name:ZARIF, MEHRUNNISA A (MD)
Entity type:Individual
Prefix:DR
First Name:MEHRUNNISA
Middle Name:A
Last Name:ZARIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 CASS CT
Mailing Address - Street 2:SUITE # 410
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2633
Mailing Address - Country:US
Mailing Address - Phone:630-620-6666
Mailing Address - Fax:
Practice Address - Street 1:1S161 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3904
Practice Address - Country:US
Practice Address - Phone:630-620-6666
Practice Address - Fax:847-843-7479
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036044846208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036044846Medicaid