Ghaderi, Bahram

Ghaderi, Bahram is an individual health care provider with primary practice located at 2900 Foxfield Road Suite 201, St. Charles IL 60174. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Ghaderi, Bahram can be contacted via phone (630) 762-9697.

Contact Information

Primary practice address
2900 Foxfield Road Suite 201 St. Charles IL 60174
Phone: (630) 762-9697
Fax: (630) 762-9721
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 036096824 Illinois

Profile Details

NPI number 1952497752
LBN Legal business name Ghaderi, Bahram
Credentials MD, FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Sep 19th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952497752 NPPES
Illinois MEDICAID 036096824
Illinois Other 04527510

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