Provider Demographics
NPI:1689630915
Name:FARAH, BEHZAD (MD)
Entity Type:Individual
Prefix:
First Name:BEHZAD
Middle Name:
Last Name:FARAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27401 W HIGHWAY 22
Mailing Address - Street 2:STE 108
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5934
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:STE 30
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-382-5350
Practice Address - Fax:847-382-5358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036059329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036059329Medicaid
D14490Medicare UPIN