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Individual
DR. FATHY Z. BASILIOS
Active
Individual
DR. FATHY Z. BASILIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-073898
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073898 3
—
IL
01
—
279500
MEDICARE GROUP
IL
Enumeration date
07/31/2006
Last updated
06/17/2008
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