Provider Demographics
NPI:1699124602
Name:FATIMA, SYEDA RABAB (OD)
Entity type:Individual
Prefix:
First Name:SYEDA
Middle Name:RABAB
Last Name:FATIMA
Suffix:
Gender:F
Credentials:OD
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Other - Credentials:
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:865 ELMHURST RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5605
Practice Address - Country:US
Practice Address - Phone:847-437-1005
Practice Address - Fax:847-437-0755
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2024-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL046.011011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist