Provider Demographics
NPI:1508983628
Name:AFSHARI, ZAHRA SARA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAHRA
Middle Name:SARA
Last Name:AFSHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 PATRIOT BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8024
Mailing Address - Country:US
Mailing Address - Phone:847-904-2298
Mailing Address - Fax:847-904-2168
Practice Address - Street 1:2634 PATRIOT BLVD STE C
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8024
Practice Address - Country:US
Practice Address - Phone:847-904-2298
Practice Address - Fax:847-904-2168
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361236182084N0400X
IL036.1236182084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1508983628OtherNPI
ILF400164413Medicaid