Provider Demographics
NPI:1659753523
Name:WAHID, FARHEEN
Entity type:Individual
Prefix:
First Name:FARHEEN
Middle Name:
Last Name:WAHID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2304
Mailing Address - Country:US
Mailing Address - Phone:708-303-9234
Mailing Address - Fax:773-729-2074
Practice Address - Street 1:6326 CERMAK RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2304
Practice Address - Country:US
Practice Address - Phone:708-303-9234
Practice Address - Fax:773-729-2074
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135000892213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery