Provider Demographics
NPI:1427423813
Name:NOORANI, AFSHEEN (APN)
Entity type:Individual
Prefix:
First Name:AFSHEEN
Middle Name:
Last Name:NOORANI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:AFSHEEN
Other - Middle Name:
Other - Last Name:GULAMHUSSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1305 S MICHIGAN AVE APT 703
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3398
Mailing Address - Country:US
Mailing Address - Phone:678-908-0040
Mailing Address - Fax:
Practice Address - Street 1:5801 S ELLIS AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-702-6189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013476363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner