Healthcare Provider Details

I. General information

NPI: 1194714816
Provider Name (Legal Business Name): FARUKH SAEED MIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 S 1ST AVE
MAYWOOD IL
60153-3328
US

IV. Provider business mailing address

1125 E SOUTHERN AVE SUITE 300
MESA AZ
85204-5045
US

V. Phone/Fax

Practice location:
  • Phone: 708-216-9000
  • Fax: 480-892-6805
Mailing address:
  • Phone: 480-545-8119
  • Fax: 480-892-6805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34181
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036144485
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: