Individual
SHAYAN FEYZI GHARAGOZLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
NESSET PAVILION 1775 BALLARD RD., PARK RIDGE, IL 60068
(847) 318-2710
Mailing address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
U8330
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10080620
TX
Other
Enumeration date
05/06/2022
Last updated
04/15/2025
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