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Organization

ASHLAND AVENUE GI, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEIKHOSROW GHAZANFARI M.D. (PRESIDENT)
(773) 871-4600
Entity
Organization

Contact information

Practice address
3004 N ASHLAND AVE, CHICAGO, IL 60657
(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
261QE0800X
Endoscopy Clinic/Center
Primary

Other

Enumeration date
08/04/2011
Last updated
08/04/2011
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