Organization
AMY FAYAZRAD & ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY FAYAZRAD FAYAZRAD (PRESIDENT)
(760) 831-1191
Entity
Organization
Contact information
Practice address
3633 W LAKE AVE STE 306, GLENVIEW, IL 60026-5803
(760) 831-1191
Mailing address
4137 N MEADE AVE, CHICAGO, IL 60634-1506
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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