# NORTH CHICAGO ORTHOPAEDIC CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043415284
- **Authorized official:** HOUSHANG FARAHVAR MD (PRESIDENT)
- **Authorized official phone:** (773) 486-7200

## Contact information

- **Practice address:** 2222 W DIVISION ST, SUITE 235, CHICAGO, IL 60622-2717
- **Practice address phone:** (773) 486-7200
- **Practice address fax:** (773) 486-7667
- **Mailing address:** PO BOX 7418, VILLA PARK, IL 60181-7418
- **Mailing address phone:** (773) 486-7200
- **Mailing address fax:** (773) 486-7667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2007
- **Last updated:** 12/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036053620 | — | IL |
| 01 | — | 200001533 | RAILROAD MEDICARE | — |