Basic Information
| Provider Information | |||||||||
| NPI: | 1275763245 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABDOL H AZARAN MD SC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16650 HARLEM AVE | ||||||||
| Address2: | |||||||||
| City: | TINLEY PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604771847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083423000 | ||||||||
| FaxNumber: | 7083423040 | ||||||||
| Practice Location | |||||||||
| Address1: | 16650 HARLEM AVE | ||||||||
| Address2: | |||||||||
| City: | TINLEY PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604771847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083423000 | ||||||||
| FaxNumber: | 7083423040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2009 | ||||||||
| LastUpdateDate: | 12/07/2009 | ||||||||
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| AuthorizedOfficialLastName: | AZARAN | ||||||||
| AuthorizedOfficialFirstName: | ABDOL | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7084814200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.