Individual
DR. SASAN PAYVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 N. MADISON AVE., JOLIET, IL 60435
(815) 741-7215
(815) 741-7591
Mailing address
333 N. MADISON AVE., JOLIET, IL 60435
(815) 741-7215
(815) 741-7591
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6124854000
DEPARTMENT OF LABOR
—
01
—
9915352
BLUE SHIELD
IL
01
—
N290487
HARMONY
IL
Enumeration date
12/27/2006
Last updated
11/20/2007
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