Latif, Suriyya Azra Maryum

Latif, Suriyya Azra Maryum is an sole proprietor health care provider with primary practice located at 3002 Grand Ave , Waukegan IL 60085-2321. She recently has 3 registered licenses in different health care specialties including Agencies / Case Management, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Latif, Suriyya Azra Maryum can be contacted via phone (847) 377-8618.

Contact Information

Primary practice address
3002 Grand Ave Waukegan IL 60085-2321
Phone: (847) 377-8618
Fax: (847) 984-5676
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1265117451
LBN Legal business name Latif, Suriyya Azra Maryum
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2023
Last updated Nov 21st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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