Healthcare Provider Details

I. General information

NPI: 1841117470
Provider Name (Legal Business Name): AMIN BAHREINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

1730 N CLARK ST APT 906
CHICAGO IL
60614-4857
US

V. Phone/Fax

Practice location:
  • Phone: 773-795-7624
  • Fax: 773-702-2126
Mailing address:
  • Phone: 315-886-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number125-089009
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: