Healthcare Provider Details

I. General information

NPI: 1316142813
Provider Name (Legal Business Name): FOUAD H HACHEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 E COURT ST
PARIS IL
61944-2460
US

IV. Provider business mailing address

721 E COURT ST
PARIS IL
61944-2460
US

V. Phone/Fax

Practice location:
  • Phone: 217-465-4141
  • Fax: 217-465-5615
Mailing address:
  • Phone: 217-465-4141
  • Fax: 217-465-5615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-32353
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: