Healthcare Provider Details

I. General information

NPI: 1902433097
Provider Name (Legal Business Name): FIRAS JADAAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 W. FOSTER AVE. SUITE 113-PRO PLAZA
CHICAGO IL
60625-3547
US

IV. Provider business mailing address

2650 RIDGE AVE
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-425-6400
  • Fax: 847-425-6408
Mailing address:
  • Phone: 608-642-3469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036173544
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: