MEDICARE: OAK BROOK CENTER FOR HEALTH II

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1467556522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK BROOK CENTER FOR HEALTH II

Provider Business Mailing Address
First Line	:	2425 W 22ND ST
Second Line	:	SUITE 200
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1245
Country	:	US
Telephone Number	:	630-990-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4313
Country	:	US
Telephone Number	:	630-990-2424
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	KIANOOSH JAFARI
Credential	:	M.D.
Telephone Number	:	630-990-2212

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	08/22/2020

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Directions to “OAK BROOK CENTER FOR HEALTH II ” Practice Location

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