Provider Demographics
NPI:1174965776
Name:NAJAFI, TINA (OD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:NAJAFI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:NAJAFI-GERMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1616 N DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5536
Mailing Address - Country:US
Mailing Address - Phone:224-201-9386
Mailing Address - Fax:
Practice Address - Street 1:1616 N DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5536
Practice Address - Country:US
Practice Address - Phone:224-201-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010712152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist