Healthcare Provider Details

I. General information

NPI: 1922592005
Provider Name (Legal Business Name): FAWAD FITTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 N WASHINGTON ST # O203
NAPERVILLE IL
60563-1366
US

IV. Provider business mailing address

704 RED OAK CT
NAPERVILLE IL
60563-3020
US

V. Phone/Fax

Practice location:
  • Phone: 630-538-8215
  • Fax: 630-278-5684
Mailing address:
  • Phone: 630-765-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.160730
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036.160730
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: