Healthcare Provider Details

I. General information

NPI: 1942519533
Provider Name (Legal Business Name): FADI KARA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20201 CRAWFORD AVE
OLYMPIA FIELDS IL
60461-1010
US

IV. Provider business mailing address

505 N MCCLURG CT UNIT 4401
CHICAGO IL
60611-5420
US

V. Phone/Fax

Practice location:
  • Phone: 708-679-2160
  • Fax: 708-679-2161
Mailing address:
  • Phone: 312-752-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125056187
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036130329
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: