Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-137440 | IL |
N | 111NI0900X | Internist | 036-137440 | IL |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036-137440 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036-137440 | IL |
NPI | 1174751978 |
---|---|
Provider Name | Ambar Afshar Andrade |
First Address | Oak Lawn, IL 60453-2600 |
Second Address | Oak Lawn, IL 60453-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 15/12/2021 |