Provider Demographics
NPI:1972376150
Name:TAGHIPOUR, ARTIN
Entity type:Individual
Prefix:
First Name:ARTIN
Middle Name:
Last Name:TAGHIPOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 CASEY CT APT 5
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5240
Mailing Address - Country:US
Mailing Address - Phone:312-848-0493
Mailing Address - Fax:
Practice Address - Street 1:2132 DEEP WATER LN STE 240
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8565
Practice Address - Country:US
Practice Address - Phone:630-217-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178018570101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty