Khazaei, Shayan
Khazaei, Shayan is an individual health care provider with primary practice located at 5 Kish Hospital Dr Ste 203 , Dekalb IL 60115-9602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Khazaei, Shayan can be contacted via phone (630) 933-4056.Contact Information
Primary practice address
5 Kish Hospital Dr Ste 203
Dekalb IL 60115-9602
Phone: (630) 933-4056
Fax: (630) 933-4057
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036150538 | Illinois |
Profile Details
| NPI number | 1114313210 |
|---|---|
| LBN Legal business name | Khazaei, Shayan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 15th, 2015 |
| Last updated | Oct 31st, 2023 - about 2 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 | 1114313210 | NPPES |
| Illinois | Other | 036150538 | STATE LICENSE |
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