Individual
DR. FAIROUZ CARPIZO CODINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1423 CHICAGO RD, UNIT 3207, CHICAGO HEIGHTS, IL 60411-3400
(708) 756-1000
Mailing address
400 E RANDOLPH ST, UNIT 3207, CHICAGO, IL 60601-7329
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036129095
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841580438
—
IL
Enumeration date
04/15/2011
Last updated
09/21/2012
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