Provider Demographics
NPI:1538107586
Name:SHAHRIAR DADKHAH MD SC
Entity Type:Organization
Organization Name:SHAHRIAR DADKHAH MD SC
Other - Org Name:GARCIA, ROSENBERG & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DADKHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-583-9189
Mailing Address - Street 1:7126 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2234
Mailing Address - Country:US
Mailing Address - Phone:847-583-9189
Mailing Address - Fax:847-583-9196
Practice Address - Street 1:7126 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2234
Practice Address - Country:US
Practice Address - Phone:847-583-9189
Practice Address - Fax:847-583-9196
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAHRIAR DADKHAH MD SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty