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General NPI Number Information
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NPI Number | 1447848585
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Entity Type | Individual
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Provider Name | FARWA RIZVI
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Gender | Female
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 217 N GREEN ST
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City | CHICAGO
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State | IL
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Zip | 60607-1701
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Country | US
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Telephone | 512-537-4052
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Fax |
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Provider Business Mailing Address
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Address Line | 103 BLUEBERRY HILL RD
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City | LONGMEADOW
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State | MA
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Zip | 01106-1661
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Country | US
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Telephone |
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019035022
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36889
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License Number State | TX
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