Chicago Electrical Trauma Research Institute

Primary specialty

Research Study SpecialistTaxonomy code 1744R1102X

Legal business name

CHICAGO ELECTRICAL TRAUMA RESEARCH INSTITUTE

Practice address

4047 W. 40TH Street
Chicago, IL 60632

Phone

(800) 516-8709

Fax

(888) 221-3183

NPI assigned

Mar 24, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Farnaz Abdollahi

Title

Assistant Director

Phone

(773) 904-0347

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1780908434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 W. 40TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "800-516-8709",
            "fax_number": "888-221-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 W. 40TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "800-516-8709",
            "fax_number": "888-221-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO ELECTRICAL TRAUMA RESEARCH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "ABDOLLAHI",
        "authorized_official_first_name": "FARNAZ",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "773-904-0347"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Research Study",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Research Study Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.