Provider Demographics
NPI:1568080174
Name:HAGHANI RAD, NASTARAN ORDOYO (MD)
Entity Type:Individual
Prefix:MS
First Name:NASTARAN
Middle Name:ORDOYO
Last Name:HAGHANI RAD
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 1:1950 W. POLK STREET, ROOM 6203
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-864-7239
Mailing Address - Fax:312-864-9725
Practice Address - Street 1:1950 W. POLK STREET, ROOM 6203
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-7239
Practice Address - Fax:312-864-9725
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program