Individual
DR. BEDER PHARAON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8747 CARLISLE CT, DARIEN, IL 60561-5373
(313) 221-0623
Mailing address
8747 CARLISLE CT, DARIEN, IL 60561-5373
(313) 221-0623
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075620A
IN
208M00000X
Hospitalist Physician
Primary
01075620A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201310750
—
IN
01
—
471400313
MEDICARE PTAN
IN
Enumeration date
06/11/2012
Last updated
10/09/2025
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