Basic Information
| Provider Information | |||||||||
| NPI: | 1073697132 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NAJJAR | ||||||||
| FirstName: | FEDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 809 S MARSHFIELD AVE | ||||||||
| Address2: | 9TH FLOOR (M/C 732) | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606124305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3129967699 | ||||||||
| FaxNumber: | 3129961001 | ||||||||
| Practice Location | |||||||||
| Address1: | 1740 W TAYLOR ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606127232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666002273 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | IL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.