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General NPI Number Information
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NPI Number | 1912261108
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Entity Type | Organization
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Legal Business Name | QUALITY NERVE CONDUCTION VELOCITIES
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 1901 RAYMOND DR SUITE 19
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City | NORTHBROOK
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State | IL
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Zip | 60062-6720
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Country | US
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Telephone | 708-345-2424
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Fax | 708-345-2626
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Provider Business Mailing Address
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Address Line | 1901 RAYMOND DR SUITE 19
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City | NORTHBROOK
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State | IL
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Zip | 60062-6720
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Country | US
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Telephone | 708-345-2424
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Fax | 708-345-2626
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL S FARHI
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Credential | M.D.
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Telephone | 708-345-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036090871
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License Number State | IL
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