Individual
DR. IRENE EFTEKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1801 W TAYLOR ST STE 2E, CHICAGO, IL 60612-4795
(312) 996-7416
(312) 413-8778
Mailing address
840 S WOOD ST # MC856, CHICAGO, IL 60612-4325
(312) 996-7416
(312) 413-0243
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
036-059992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-059992-4
—
IL
01
—
E24704
MEDICARE ID
IL
Enumeration date
02/23/2006
Last updated
04/24/2013
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