Provider Demographics
NPI:1902135668
Name:CIFTCI, FARAH DIBA (MD)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:DIBA
Last Name:CIFTCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FARAH
Other - Middle Name:D
Other - Last Name:CIFTCI OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2434 N SPAULDING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-933-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.123791174400000X
IL036123791207R00000X, 281P00000X, 282N00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No281P00000XHospitalsChronic Disease Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036123791Medicaid
ILF400416637OtherMEDICARE INDIVIDUAL
WI1902135668Medicaid
IL206147OtherMEDICARE GROUP