Provider Demographics
NPI:1134809726
Name:AMIR DORAFSHAR, M.D., S.C.
Entity type:Organization
Organization Name:AMIR DORAFSHAR, M.D., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:HOSSEIN
Authorized Official - Last Name:DORAFSHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-371-4248
Mailing Address - Street 1:23055 SHERMAN WAY UNIT 4245
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91308-7015
Mailing Address - Country:US
Mailing Address - Phone:312-371-4248
Mailing Address - Fax:
Practice Address - Street 1:60 E DELAWARE PL STE 1430
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1495
Practice Address - Country:US
Practice Address - Phone:312-278-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty