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Contact Information

OLIVIA BANIFAZL
2522 FOREST VIEW AVE
RIVER GROVE, IL60171-1602
 Phone: 312-813-4465
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for OLIVIA BANIFAZL · (Female)

NPI Number 1841047248
Status Active
Credentials
Entity Individual
Enumeration date 05/02/2024
Last updated 05/02/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 198.001652
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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