Basic Information
| Provider Information | |||||||||
| NPI: | 1003077900 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAUDHRY | ||||||||
| FirstName: | FARRUKH | ||||||||
| MiddleName: | SALIM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17W775 KIRKLAND LN | ||||||||
| Address2: | |||||||||
| City: | VILLA PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164173146 | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 MACARTHUR BLVD | ||||||||
| Address2: | |||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463212901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198361600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2008 | ||||||||
| LastUpdateDate: | 02/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084V0102X | 01081110A | IN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2084V0102X | 036130959 | IL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2084A2900X | 01081110A | IN | Y |
No ID Information.