Organization
FARAMARZ EGHRARI, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARAMARZ EGHRARI M.D. (ADMINISTRATOR)
(708) 343-7451
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST, SUITE 409, MELROSE PARK, IL 60160-4138
(708) 343-7451
Mailing address
1111 SUPERIOR ST, SUITE 409, MELROSE PARK, IL 60160-4138
(708) 343-7451
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600651
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
01/16/2007
Last updated
08/22/2020
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