Healthcare Provider Details

I. General information

NPI: 1144299256
Provider Name (Legal Business Name): AFSOON KARIMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 LAUREL LN
DARIEN IL
60561-5327
US

IV. Provider business mailing address

1617 LAUREL LN
DARIEN IL
60561-5327
US

V. Phone/Fax

Practice location:
  • Phone: 312-371-7958
  • Fax: 708-345-8965
Mailing address:
  • Phone: 312-371-7958
  • Fax: 708-345-8965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036110016
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number036110016
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: