Individual
FAZILLAH FAIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4000 N ILLINOIS LN, SWANSEA, IL 62226-1969
(618) 257-6380
Mailing address
4000 N ILLINOIS LN, SWANSEA, IL 62226-1969
(618) 257-6380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009213
IL
363A00000X
Physician Assistant
2020028648
MO
Other
Enumeration date
11/01/2019
Last updated
02/13/2023
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