Provider Demographics
NPI:1497125785
Name:SOHRABI, HAYEDEH (WHNP)
Entity Type:Individual
Prefix:
First Name:HAYEDEH
Middle Name:
Last Name:SOHRABI
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 111TH ST
Mailing Address - Street 2:SUITE 507
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-4215
Mailing Address - Country:US
Mailing Address - Phone:708-434-4075
Mailing Address - Fax:708-434-4079
Practice Address - Street 1:1010 LAKE ST
Practice Address - Street 2:SUITE 507
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1147
Practice Address - Country:US
Practice Address - Phone:708-434-4075
Practice Address - Fax:708-434-4079
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209012152363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology