Individual
DR. EHSAN SAFARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
430 PENNSYLVANIA AVE, 110, GLEN ELLYN, IL 60137-4464
(630) 545-7880
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-102351
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102361
—
IL
Enumeration date
08/31/2006
Last updated
08/18/2023
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