Provider Demographics
NPI:1841284577
Name:ZAHRAN, NASER A (MD)
Entity type:Individual
Prefix:DR
First Name:NASER
Middle Name:A
Last Name:ZAHRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:BOX 152, ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2605
Mailing Address - Country:US
Mailing Address - Phone:773-880-6903
Mailing Address - Fax:773-880-3068
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:OUTREACH PHYSICIAN SERVICES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2605
Practice Address - Country:US
Practice Address - Phone:773-880-6903
Practice Address - Fax:773-880-3068
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-093808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093808Medicaid