Provider Demographics
NPI:1053874107
Name:AZIZADDINI, SHAHRZAD (MD)
Entity type:Individual
Prefix:
First Name:SHAHRZAD
Middle Name:
Last Name:AZIZADDINI
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:PO BOX 71736
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60694-1736
Mailing Address - Country:US
Mailing Address - Phone:630-856-7460
Mailing Address - Fax:630-655-9943
Practice Address - Street 1:911 N ELM ST STE 128
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3640
Practice Address - Country:US
Practice Address - Phone:630-856-7460
Practice Address - Fax:630-655-9943
Is Sole Proprietor?:No
Enumeration Date:2019-04-07
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0116038860390200000X
IL036.1744362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program