Provider Demographics
NPI:1366423576
Name:SALEEM, RAFIA S (MD)
Entity type:Individual
Prefix:
First Name:RAFIA
Middle Name:S
Last Name:SALEEM
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 1:7049 CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2137
Mailing Address - Country:US
Mailing Address - Phone:708-788-8900
Mailing Address - Fax:708-788-5110
Practice Address - Street 1:7049 CERMAK RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2137
Practice Address - Country:US
Practice Address - Phone:708-788-8900
Practice Address - Fax:708-788-5110
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010341492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100360330Medicaid
IN100360330Medicaid
IND13800Medicare UPIN