Provider Demographics
NPI:1275880270
Name:MOHAMMED, FARAH PARVEEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:PARVEEN
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3291
Mailing Address - Country:US
Mailing Address - Phone:708-484-3338
Mailing Address - Fax:
Practice Address - Street 1:3100 OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3291
Practice Address - Country:US
Practice Address - Phone:708-484-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005513213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery