Michel Gowhari, DO | |
1740 W Taylor St, Chicago, IL 60612-7232 | |
(866) 600-2273 | |
Not Available |
Full Name | Michel Gowhari |
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Gender | Male |
Speciality | Internal Medicine |
Location | 1740 W Taylor St, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851405385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036109115 (Illinois) | Primary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Mailing Address | Practice Location Address |
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Michel Gowhari, DO 912 S Wood St, B-32 Npi, Mc 713, Chicago, IL 60612-4300 Ph: (312) 996-5681 | Michel Gowhari, DO 1740 W Taylor St, Chicago, IL 60612-7232 Ph: (866) 600-2273 |
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