Provider Demographics
NPI:1417530502
Name:HAMEDI, BAHAREH (MD)
Entity type:Individual
Prefix:
First Name:BAHAREH
Middle Name:
Last Name:HAMEDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3814
Mailing Address - Country:US
Mailing Address - Phone:630-978-2532
Mailing Address - Fax:507-266-7953
Practice Address - Street 1:400 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3814
Practice Address - Country:US
Practice Address - Phone:630-978-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2025-07-18
Deactivation Date:2022-04-28
Deactivation Code:
Reactivation Date:2022-07-01
Provider Licenses
StateLicense IDTaxonomies
MN71845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology