Provider Demographics
NPI:1518909399
Name:FARAMARZ SALIMI MD SC
Entity Type:Organization
Organization Name:FARAMARZ SALIMI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAMARZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-778-8247
Mailing Address - Street 1:6420 LYONS ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1421
Mailing Address - Country:US
Mailing Address - Phone:773-778-8247
Mailing Address - Fax:312-791-8359
Practice Address - Street 1:2800 S VERNON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3557
Practice Address - Country:US
Practice Address - Phone:312-791-2876
Practice Address - Fax:312-792-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01826Medicare UPIN