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General NPI Number Information
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NPI Number | 1881705937
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Entity Type | Organization
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Legal Business Name | OAK BROOK ANESTHESIOLOGISTS, LTD.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 2425 W 22ND ST SUITE 101
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City | OAK BROOK
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State | IL
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Zip | 60523-4642
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Country | US
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Telephone | 630-990-2212
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Fax | 630-990-3130
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Provider Business Mailing Address
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Address Line | 2425 W 22ND ST SUITE 101
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City | OAK BROOK
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State | IL
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Zip | 60523-4642
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Country | US
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Telephone | 630-990-2212
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Fax | 630-990-3130
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KIANOOSH JAFARI
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Credential | M.D.
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Telephone | 630-990-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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