Provider Demographics
NPI:1174710131
Name:IRAJ DELFANI M.D. S.C.
Entity type:Organization
Organization Name:IRAJ DELFANI M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:DELFANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-728-4303
Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3500
Mailing Address - Country:US
Mailing Address - Phone:773-728-4303
Mailing Address - Fax:773-728-4243
Practice Address - Street 1:2740 W FOSTER AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3500
Practice Address - Country:US
Practice Address - Phone:773-728-4303
Practice Address - Fax:773-728-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty