Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036143343 | IL |
NPI | 1003158403 |
---|---|
Provider Name | Dr. Liza A Dafchahi Shirani |
First Address | Chicago, IL 60657-5147 |
Second Address | Chicago, IL 60657-5147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2013 |
Last Update Date | 20/03/2018 |