Individual
KEIKHOSROW GHAZANFARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3004 N ASHLAND AVE, CHICAGO, IL 60657-3012
(773) 871-4600
(773) 871-2900
Mailing address
3004 N ASHLAND AVE, CHICAGO, IL 60657-3012
(773) 871-4600
(773) 871-2900
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036047888
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047888
—
IL
Enumeration date
10/14/2005
Last updated
10/12/2012
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