Provider Demographics
NPI:1275272718
Name:YASHAR GHORESHI DC LTD ADVANCED HEALTH & PAIN CENTER
Entity Type:Organization
Organization Name:YASHAR GHORESHI DC LTD ADVANCED HEALTH & PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YASHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHORESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-620-3692
Mailing Address - Street 1:2016 W CHICAGO AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5548
Mailing Address - Country:US
Mailing Address - Phone:312-620-3692
Mailing Address - Fax:312-668-8603
Practice Address - Street 1:2016 W CHICAGO AVE FL 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5548
Practice Address - Country:US
Practice Address - Phone:312-620-3692
Practice Address - Fax:312-668-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty