Individual
BEHFAR DIANATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4550 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226-5372
(618) 257-6200
(618) 257-6679
Mailing address
4550 MEMORIAL DR, STE. 340, BELLEVILLE, IL 62226-5372
(618) 257-6200
(618) 257-6679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036124202
IL
208M00000X
Hospitalist Physician
036124202
IL
208M00000X
Hospitalist Physician
Primary
2007018749
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036124202
STATE LICENSE
IL
05
—
1558580852
—
IL
05
—
207340605
—
MO
Enumeration date
04/25/2007
Last updated
05/27/2025
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