Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036138882 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036138882 | IL |
NPI | 1679733620 |
---|---|
Provider Name | Kambiz Ghafourian |
First Address | Chicago, IL 60611-5969 |
Second Address | Chicago, IL 60611-5969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 07/02/2020 |