Individual
DR. AZADEH GHAFFARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2502 N CLARK ST STE 206, CHICAGO, IL 60614-1850
(773) 850-0294
Mailing address
2502 N CLARK ST STE 206, CHICAGO, IL 60614-1850
(773) 850-0294
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008535
IL
103TH0004X
Health Psychologist
071008535
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821540428
NPI2
IL
Enumeration date
02/13/2013
Last updated
02/06/2019
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