Individual
FARAMARZ EGHRARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 SUPERIOR ST, SUITE 409, MELROSE PARK, IL 60160-4138
(708) 343-7451
Mailing address
1111 SUPERIOR ST, SUITE 409, MELROSE PARK, IL 60160-4138
(708) 343-7451
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036049491
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600651
BLUE CROSS BLUE SHIELD
IL
05
—
036049491
—
IL
Enumeration date
03/01/2007
Last updated
07/08/2007
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