Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maryam Gheisarifar

Individual provider Prosthodontics · NPI 1831731116

Maryam Gheisarifar is a Prosthodontics in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2019

Practice location Address checks out

801 S Paulina St
Chicago, IL 60612-7210
Phone: (414) 808-5822
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthodontics (primary) Taxonomy 1223P0700X · Licence 019.033384 (IL)

Record details

NPI number1831731116
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 8, 2019
Last updated in NPPESSeptember 25, 2023
Certification dateSeptember 25, 2023

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