Provider Demographics
NPI:1679374334
Name:FURRUKH, ANAM JEHAN
Entity type:Individual
Prefix:
First Name:ANAM
Middle Name:JEHAN
Last Name:FURRUKH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 N MINNEHAHA AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3109
Mailing Address - Country:US
Mailing Address - Phone:847-668-3359
Mailing Address - Fax:
Practice Address - Street 1:6712 N MINNEHAHA AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-3109
Practice Address - Country:US
Practice Address - Phone:847-668-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program