MEDICARE: DR. AMIR HOSSEIN VAFA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0102X	Surgical Critical Care Physician	036116160	IL
2	208600000X	Surgery Physician	036116160	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036116160	OTHER	IL	PHYSICIAN AND SURGEON LIC

General Provider Information

NPI Number	:	1881818326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIR HOSSEIN VAFA MD

Provider Business Mailing Address
First Line	:	1500 S FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1782
Country	:	US
Telephone Number	:	773-257-4752
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1782
Country	:	US
Telephone Number	:	773-257-6464
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	04/29/2025

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