Provider Demographics
NPI:1346769130
Name:BOHRI, ZAHRA
Entity Type:Individual
Prefix:
First Name:ZAHRA
Middle Name:
Last Name:BOHRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZAHRA
Other - Middle Name:
Other - Last Name:HASSANALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6337 BLODGETT AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3026
Mailing Address - Country:US
Mailing Address - Phone:312-919-6943
Mailing Address - Fax:
Practice Address - Street 1:6337 BLODGETT CT
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516
Practice Address - Country:US
Practice Address - Phone:703-216-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered