Healthcare Provider Details

I. General information

NPI: 1851376909
Provider Name (Legal Business Name): MARTIN BORHANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST STE 2E
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

815 S STOUGH ST
HINSDALE IL
60521-4352
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-7001
  • Fax: 405-271-7034
Mailing address:
  • Phone: 630-561-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number036089937
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number46752
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: