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Individual

MR. RUSTAM SAFAROV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
10 N MILWAUKEE AVE, WHEELING, IL 60090-3012
(800) 323-8622
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.019746
IL
363LF0000X
Family Nurse Practitioner
F03190845
IL

Other

Enumeration date
04/28/2019
Last updated
09/16/2024
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