Individual
FAZL KHADEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
5817 W CHERRY CT, VISALIA, CA 93277-8873
(847) 313-5740
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/23/2022
Last updated
03/30/2023
About Stedi
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