Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 036115555 | IL |
Y | 207RI0011X | Interventional Cardiology | 036115555 | IL |
NPI | 1073577193 |
---|---|
Provider Name | Dr. Jaafer A Golzar |
First Address | Oak Lawn, IL 60453-6459 |
Second Address | Oak Lawn, IL 60453-6459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01621208 | BLUECROSS BLUE SHIELD (01) | IL |
036115555 | (05) | IL |
1508810086 | GROUP NPI (01) | IL |
1528165768 | GROUP NPI NUMBER (01) | IL |
21622931 | BCBS GROUP PROVIDER NUMBER (01) | IL |
236550 | MEDICARE GROUP (01) | IL |
236551 | MEDICARE GROUP (01) | IL |
416810 | MEDICARE GROUP (01) | IL |
526200 | MEDICARE GROUP NUMBER (01) | IL |
CD8033 | RAILROAD MEDICARE GROUP PTAN NUMBER (01) | IL |
CI8250 | PALMETTO GBA GROUP # (01) | IL |
CN2703 | RAILROAD MEDICARE GROUP PTAN NUMBERS (01) | IL |
I30555 | (02) | |
P00318032 | RAILROAD MEDICARE COOK (01) | IL |
P00321102 | RAILROAD MEDICARE WILL (01) | IL |