1518909399 NPI number — FARAMARZ SALIMI MD SC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518909399 NPI number — FARAMARZ SALIMI MD SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARAMARZ SALIMI MD SC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518909399
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6420 LYONS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORTON GROVE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60053-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-778-8247
Provider Business Mailing Address Fax Number:
312-791-8359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 S VERNON AVE
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60616-3557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-791-2876
Provider Business Practice Location Address Fax Number:
312-792-8359
Provider Enumeration Date:
06/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SALIMI
Authorized Official First Name:
FARAMARZ
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
773-778-8247

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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