Provider Demographics
NPI:1083916845
Name:MIR JOFFREY MD, LLC
Entity Type:Organization
Organization Name:MIR JOFFREY MD, LLC
Other - Org Name:SMART SINUS AND ALLERGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SURGEON/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:JAFER
Authorized Official - Last Name:JOFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-278-1885
Mailing Address - Street 1:1100 E WOODFIELD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5116
Mailing Address - Country:US
Mailing Address - Phone:847-278-1885
Mailing Address - Fax:630-635-2496
Practice Address - Street 1:1100 E WOODFIELD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5116
Practice Address - Country:US
Practice Address - Phone:847-278-1885
Practice Address - Fax:630-635-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.122339202K00000X, 207YX0905X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty