Individual
SHAYAN FAYAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
7850 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1010
(872) 231-3162
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.024200
IL
Other
Enumeration date
12/06/2022
Last updated
10/03/2025
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