Provider Demographics
NPI:1043211451
Name:SAGHIR, FARHA (DO)
Entity Type:Individual
Prefix:
First Name:FARHA
Middle Name:
Last Name:SAGHIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 N PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4622
Mailing Address - Country:US
Mailing Address - Phone:630-469-0045
Mailing Address - Fax:630-469-0645
Practice Address - Street 1:444 N PARK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4622
Practice Address - Country:US
Practice Address - Phone:630-469-0045
Practice Address - Fax:630-469-0645
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3137207Q00000X
NH11749207Q00000X
WI54953-21207Q00000X
IL036-116680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04YPO4564NH01OtherANTHEM BC/BS
NHLICENSEOther11749
NH30222222Medicaid
IL036116680Medicaid
020350051OtherFEDERAL TAX ID
5830418OtherAETNA GROUP
NH1600915OtherCIGNA HEALTHCARE
080194915OtherRAILROAD MEDICARE
ILK31109Medicare ID - Type Unspecified
NHLICENSEOther11749
NH04YPO4564NH01OtherANTHEM BC/BS
NHH69706Medicare UPIN