Provider Demographics
NPI:1003339482
Name:SAFAR BOUERI, MARIA LUISA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LUISA
Last Name:SAFAR BOUERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:676 NORTH SAINT CLAIR STREET
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:312-695-8900
Mailing Address - Fax:312-695-7752
Practice Address - Street 1:676 NORTH SAINT CLAIR STREET
Practice Address - Street 2:SUITE 1900
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-695-8900
Practice Address - Fax:312-695-7752
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA272586390200000X
IL036.158325207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program