Provider Demographics
NPI:1922212539
Name:ASHOURIAN, NEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:ASHOURIAN
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 1:2040 N LINCOLN AVE APT C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4685
Mailing Address - Country:US
Mailing Address - Phone:773-510-8615
Mailing Address - Fax:
Practice Address - Street 1:737 N MICHIGAN AVE STE 2310
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2635
Practice Address - Country:US
Practice Address - Phone:312-266-6647
Practice Address - Fax:312-266-6612
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.118234207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology