Individual
DR. SHAHROOZ SEPAHDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-0235
Mailing address
1740 W TAYLOR ST # MC931, CHICAGO, IL 60612-7232
(312) 996-0235
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036060444
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060444
—
IL
Enumeration date
05/08/2006
Last updated
03/07/2023
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