Individual
FARNAZ NANI MOAZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 S 13TH ST, # I, PEKIN, IL 61554-4936
(309) 495-0200
(309) 353-4380
Mailing address
600 S 13TH ST, # I, PEKIN, IL 61554-4936
(309) 495-0200
(309) 353-4380
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036101798
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101798
—
IL
Enumeration date
07/29/2006
Last updated
01/13/2025
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