MEDICARE: DR. FARAH FAIZAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	036166867	IL
2	207R00000X	Internal Medicine Physician	036.166867	IL

General Provider Information

NPI Number	:	1265060990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARAH FAIZAN MD

Provider Business Mailing Address
First Line	:	836 W WELLINGTON AVE STE 1312
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5147
Country	:	US
Telephone Number	:	773-296-7046
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 W WELLINGTON AVE STE 1312
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5147
Country	:	US
Telephone Number	:	773-296-7046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	02/04/2026

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