Organization
FARHAD VOSSOUGHI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD VOSSOUGHI MD (OWNER / PHYSICIAN)
(630) 321-2710
Entity
Organization
Contact information
Practice address
3825 HIGHLAND AVE, SUITE 2B, DOWNERS GROVE, IL 60515-1552
(630) 646-2987
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
01
—
0002201788
BCBS OF IL
IL
Enumeration date
07/17/2006
Last updated
01/23/2009
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