Healthcare Provider Details

I. General information

NPI: 1861303943
Provider Name (Legal Business Name): ARMIN PASHAEIMOFRAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 S WOOD ST
CHICAGO IL
60612-7229
US

IV. Provider business mailing address

706 S LAFLIN ST APT 2R
CHICAGO IL
60607-3147
US

V. Phone/Fax

Practice location:
  • Phone: 815-909-7076
  • Fax:
Mailing address:
  • Phone: 815-909-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number051.306541
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: