Individual
MR. HOOSHMOND KADKHODAIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 S MICHIGAN AVE, BEHAVIORAL HEALTH, CHICAGO, IL 60616-2333
(312) 562-2295
(312) 328-7808
Mailing address
2525 S MICHIGAN AVE, BEHAVIORAL HEALTH, CHICAGO, IL 60616-2333
(312) 567-2295
(312) 328-7808
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036046530
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036046530
—
IL
Enumeration date
11/29/2005
Last updated
07/13/2016
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