Provider Demographics
NPI:1912261108
Name:QUALITY NERVE CONDUCTION VELOCITIES
Entity type:Organization
Organization Name:QUALITY NERVE CONDUCTION VELOCITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:FARHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-345-2424
Mailing Address - Street 1:1901 RAYMOND DR
Mailing Address - Street 2:SUITE 19
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6720
Mailing Address - Country:US
Mailing Address - Phone:708-345-2424
Mailing Address - Fax:708-345-2626
Practice Address - Street 1:1901 RAYMOND DR
Practice Address - Street 2:SUITE 19
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6720
Practice Address - Country:US
Practice Address - Phone:708-345-2424
Practice Address - Fax:708-345-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360908712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL7715Medicare PIN