Healthcare Provider Details

I. General information

NPI: 1740978618
Provider Name (Legal Business Name): FIRAS RABIH DARWICHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 JOE DR E
AMBOY IL
61310-9492
US

IV. Provider business mailing address

305 JOE DR E
AMBOY IL
61310-9492
US

V. Phone/Fax

Practice location:
  • Phone: 815-857-3044
  • Fax: 815-285-7870
Mailing address:
  • Phone: 815-857-3044
  • Fax: 815-285-7870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125082842
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: