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Individual

BEJAN J FAKOURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1259 RICKERT DR, STE 200, NAPERVILLE, IL 60540-8904
(630) 369-1572
(630) 369-6139
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-8904
(630) 469-2000

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036099752
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036099752
IL
Enumeration date
05/05/2006
Last updated
01/26/2021
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