Individual
FAHD JAJEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1870 W WINCHESTER RD STE 241, LIBERTYVILLE, IL 60048-5360
(847) 549-0170
(847) 549-0170
Mailing address
1870 W WINCHESTER RD STE 241, LIBERTYVILLE, IL 60048-5360
(847) 549-0170
(847) 549-0170
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036064762
IL
207RC0000X
Cardiovascular Disease Physician
29871020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064762
—
IL
01
—
165845
MPIN
IL
01
—
4277452
AETNA
IL
Enumeration date
09/08/2005
Last updated
12/22/2021
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