Provider Demographics
NPI:1467616193
Name:JAHROMI, BABAK S (MD)
Entity Type:Individual
Prefix:DR
First Name:BABAK
Middle Name:S
Last Name:JAHROMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:312-695-6200
Mailing Address - Fax:312-695-0225
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 2210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-695-6200
Practice Address - Fax:312-695-0225
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249395207T00000X
IL036139135207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03023741Medicaid
NYRB9144Medicare PIN