Provider Demographics
NPI:1093810491
Name:BARHAMAND, FARIBORZE B (MD)
Entity Type:Individual
Prefix:MR
First Name:FARIBORZE
Middle Name:B
Last Name:BARHAMAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 ANNE RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5504
Mailing Address - Country:US
Mailing Address - Phone:630-567-0409
Mailing Address - Fax:630-369-1560
Practice Address - Street 1:100 SPALDING DR
Practice Address - Street 2:STE 110
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-369-1501
Practice Address - Fax:630-369-1560
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-053994207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053994Medicaid
IL640600Medicare ID - Type Unspecified
C44499Medicare UPIN