Provider Demographics
NPI:1619149820
Name:BEHZAD FARAH MD SC
Entity Type:Organization
Organization Name:BEHZAD FARAH MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-382-5350
Mailing Address - Street 1:27790 W HIGHWAY 22
Mailing Address - Street 2:SUITE 30
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2340
Mailing Address - Country:US
Mailing Address - Phone:847-382-5350
Mailing Address - Fax:847-382-5358
Practice Address - Street 1:27790 W HIGHWAY 22
Practice Address - Street 2:SUITE 30
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2340
Practice Address - Country:US
Practice Address - Phone:847-382-5350
Practice Address - Fax:847-382-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD14490Medicare UPIN