Healthcare Provider Details

I. General information

NPI: 1134188287
Provider Name (Legal Business Name): FARID SAHEB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 09/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 N CUMBERLAND AVE
NORRIDGE IL
60706-2916
US

IV. Provider business mailing address

44 BRADFORD LN
OAK BROOK IL
60523-2322
US

V. Phone/Fax

Practice location:
  • Phone: 312-910-3588
  • Fax:
Mailing address:
  • Phone: 312-910-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036046314
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: