MEDICARE: SOHEILA VAHABI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	38008001	IL

General Provider Information

NPI Number	:	1184805947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHEILA VAHABI

Provider Business Mailing Address
First Line	:	1603 ORRINGTON AVE STE 600
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-3860
Country	:	US
Telephone Number	:	312-774-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	4705 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2009
Country	:	US
Telephone Number	:	312-774-0010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2007
Last Update Date	:	04/21/2020

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Directions to “ SOHEILA VAHABI ” Practice Location

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