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Individual

B FLORIAN MIRANZADEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3718 N ASHLAND AVE, CHICAGO, IL 60613-4793
(773) 327-9900
(773) 327-0589
Mailing address
3718 N ASHLAND AVE, CHICAGO, IL 60613-4793
(773) 327-9900
(773) 327-0589

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036100398
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01629934
BCBS PROVIDER ID
IL
05
036100398
IL
01
080171110
RAILROAD MEDICARE
IL
01
4010133
ADVOCATE IL MASONIC
IL
Enumeration date
09/20/2005
Last updated
08/19/2025
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