Individual
ABED ALFATTAH ABU FARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 N ALLEN ST STE B, ROBINSON, IL 62454-1168
(917) 445-5531
(618) 546-2634
Mailing address
1101 N ALLEN ST STE B, ROBINSON, IL 62454-1168
(618) 546-5464
(618) 546-2634
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036154929
IL
207R00000X
Internal Medicine Physician
329587
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
NY
Enumeration date
06/30/2018
Last updated
07/02/2024
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