Individual
DR. ABDOL AZARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15614 S HARLEM AVE, SUITE C, ORLAND PARK, IL 60462-4402
(708) 481-4200
(708) 481-3302
Mailing address
PO BOX 219, MATTESON, IL 60443-0219
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036058380
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058380
—
IL
01
—
324853
MEDICARE GROUP
IL
01
—
CE0254
RAILROAD MEDICARE GROUP
IL
01
—
P00760044
RR MEDICARE
IL
Enumeration date
07/28/2005
Last updated
12/04/2014
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