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General NPI Number Information
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NPI Number | 1306832829
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Entity Type | Individual
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Provider Name | BAHRAM RAHMANI MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 225 EAST CHICAGO AVE. DIVISION OF PEDIATRIC OPTHALMOLOGY
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 800-543-7362
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Fax | 312-227-9411
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Provider Business Mailing Address
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Address Line | 225 EAST CHICAGO AVE. DIVISION OF PEDIATRIC OPTHALMOLOGY
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 800-543-7362
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Fax | 312-227-9411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036109049
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License Number State | IL
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