Look up the most recent NPI and PECOS records

Eli Forouzan

Surgery

Allopathic & Osteopathic Physicians

1620 W Harrison St, Chicago, IL 60612-3801

PECOS Enrollment

Based on the most recent information from CMS, provider Eli Forouzan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1184466088
Provider Type
Individual
Full Name
Forouzan, Eli
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
6/11/2024
Last Updated
6/11/2024

Contact Information

Practice Location

1620 W Harrison St, Chicago, IL 60612-3801

(312) 942-5000

Unlisted Fax

Mailing Location

1620 W Harrison St, Chicago, IL 60612-3801

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208600000X Primary	Description Surgery Allopathic & Osteopathic Physicians	License 125.083640 Illinois

Eli Forouzan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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