Provider Demographics
NPI:1528706124
Name:NIROUMANDPOUR, FARAHNAZ (DC)
Entity type:Individual
Prefix:DR
First Name:FARAHNAZ
Middle Name:
Last Name:NIROUMANDPOUR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-9681
Mailing Address - Country:US
Mailing Address - Phone:847-529-9630
Mailing Address - Fax:
Practice Address - Street 1:1096 NATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4519
Practice Address - Country:US
Practice Address - Phone:847-306-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor