Individual
AMANI FAWZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
675 N SAINT CLAIR ST, CHICAGO, IL 60611-5975
(312) 695-8150
(312) 695-0050
Mailing address
680 N LAKE SHORE DR, SUITE#1000, CHICAGO, IL 60611-4546
(312) 695-8150
(312) 695-0050
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036129455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036129455
LICENSE
IL
05
—
036129455
—
IL
01
—
A80549
LICENSE
CA
Enumeration date
01/24/2007
Last updated
04/24/2015
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