Provider Demographics
NPI:1255412193
Name:TAKHTEHCHIAN, DARIUSH SAM (MD)
Entity type:Individual
Prefix:DR
First Name:DARIUSH
Middle Name:SAM
Last Name:TAKHTEHCHIAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 S PROSPECT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5643
Mailing Address - Country:US
Mailing Address - Phone:630-782-0190
Mailing Address - Fax:
Practice Address - Street 1:5TH ROOSEVELT ROAD
Practice Address - Street 2:EDWARD HINES, JR HOSPITAL
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2021-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-106592207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease