Foroutan, Mardjan
Foroutan, Mardjan is an sole proprietor health care provider with primary practice located at 2111 Midlands Ct Suite 202, Sycamore IL 60178-3125. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Foroutan, Mardjan can be contacted via phone (630) 222-5574.Contact Information
Primary practice address
2111 Midlands Ct Suite 202
Sycamore IL 60178-3125
Phone: (630) 222-5574
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 036110360 | Illinois |
Profile Details
| NPI number | 1619900024 |
|---|---|
| LBN Legal business name | Foroutan, Mardjan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 9th, 2006 |
| Last updated | Sep 29th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619900024 | NPPES |
| Illinois | MEDICAID | 036110360 |
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