Organization
NORTH CHICAGO ORTHOPAEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOUSHANG FARAHVAR MD (PRESIDENT)
(773) 486-7200
Entity
Organization
Contact information
Practice address
2222 W DIVISION ST, SUITE 235, CHICAGO, IL 60622-2717
(773) 486-7200
(773) 486-7667
Mailing address
PO BOX 7418, VILLA PARK, IL 60181-7418
(773) 486-7200
(773) 486-7667
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053620
—
IL
01
—
200001533
RAILROAD MEDICARE
—
Enumeration date
06/18/2007
Last updated
12/13/2007
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