Individual
DR. ANTON JIRIES FAKHOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
(708) 237-7200
(708) 237-7201
Mailing address
10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
(708) 237-7200
(708) 237-7201
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-084909
IL
207XS0106X
Orthopaedic Hand Surgery Physician
036-084909
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00973095
RAILROAD MEDICARE PTAN
IL
Enumeration date
05/16/2006
Last updated
12/20/2021
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