Healthcare Provider Details

I. General information

NPI: 1679107049
Provider Name (Legal Business Name): NIKKI NEGIN FARSI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NEGIN FARSI MD

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST STE 7-132I
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

251 E HURON ST STE 7-132I
CHICAGO IL
60611-2908
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-7913
  • Fax: 312-926-3127
Mailing address:
  • Phone: 312-926-7913
  • Fax: 312-926-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036176416
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number72826
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: