Individual
FARHAD VOSSOUGHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(630) 321-2710
Mailing address
PO BOX 967, TINLEY PARK, IL 60477-0967
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036053514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053514
—
IL
Enumeration date
07/17/2006
Last updated
07/16/2008
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