Provider Demographics
NPI:1275710782
Name:BARKHORDAR, FARSHAD S (DC)
Entity Type:Individual
Prefix:
First Name:FARSHAD
Middle Name:S
Last Name:BARKHORDAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7541 W IRVING PARK RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2105
Mailing Address - Country:US
Mailing Address - Phone:773-589-9692
Mailing Address - Fax:773-304-1400
Practice Address - Street 1:7541 W IRVING PARK RD
Practice Address - Street 2:UNIT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2105
Practice Address - Country:US
Practice Address - Phone:773-589-9692
Practice Address - Fax:773-304-1400
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038-011040OtherSTATE LICENSE NUMBER