Individual
MANIJEH GHAFOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 CENTRAL ST, EVANSTON, IL 60201-1150
(847) 869-3800
Mailing address
331 GLENVIEW RD, GLENVIEW, IL 60025-3362
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
277.000199
IL
363LF0000X
Family Nurse Practitioner
Primary
309.003894
IL
Other
Enumeration date
08/27/2008
Last updated
09/29/2021
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