Individual
FARZIN BANIASSADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3637 N SOUTHPORT AVE, CHICAGO, IL 60613-3709
(773) 348-5282
Mailing address
3637 N SOUTHPORT AVE, CHICAGO, IL 60613-3709
(773) 348-5282
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288449
IL
Other
Enumeration date
11/22/2020
Last updated
11/22/2020
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