| Foroutan & Associates Sc | |
|
2111 Midlands Ct Suite 202 Sycamore IL 60178-3125 | |
| (630) 222-5574 | |
| Not Available |
| Full Name | Foroutan & Associates Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2111 Midlands Ct, Sycamore, Illinois |
| Authorized Official Name and Position | Mardjan Foroutan (OWNER) |
| Authorized Official Contact | 6302225574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foroutan & Associates Sc 920 W Prairie Dr Ste I Sycamore IL 60178-3123 Ph: (708) 532-6029 | Foroutan & Associates Sc 2111 Midlands Ct Suite 202 Sycamore IL 60178-3125 Ph: (630) 222-5574 |
| NPI Number | 1063445476 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 05/21/2015 |
| Medicare PECOS PAC ID | 4688670284 |
|---|---|
| Medicare Enrollment ID | O20061004000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063445476 | NPI | - | NPPES |
| 0001932083 | Other | IL | BCBS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036110360 (Illinois) | Primary |
| Provider Name | Mardjan Foroutan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619900024 PECOS PAC ID: 6103880133 Enrollment ID: I20041118000548 |
| Provider Name | Michael L Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871568931 PECOS PAC ID: 4880981448 Enrollment ID: I20160926000329 |
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