Provider Demographics
NPI:1437222791
Name:HADI, FATIMA M (MD)
Entity type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:M
Last Name:HADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FATIMA
Other - Middle Name:
Other - Last Name:MEHJABEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 QUARTERHORSE CT
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-5816
Mailing Address - Country:US
Mailing Address - Phone:630-443-0579
Mailing Address - Fax:
Practice Address - Street 1:455 DUNHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1453
Practice Address - Country:US
Practice Address - Phone:630-770-3475
Practice Address - Fax:331-901-5127
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361098932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH97413Medicare ID - Type Unspecified