Individual
MARDIA ELFAKHERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1653 W CONGRESS PARKWAY, CHICAGO, IL 60612
(312) 942-2729
Mailing address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1205070512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205070512
IDFPR
IL
Enumeration date
06/08/2017
Last updated
06/08/2017
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