Healthcare Provider Details

I. General information

NPI: 1497011266
Provider Name (Legal Business Name): MARWAH W FAROOQUI D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE # WRB7284
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE # WRB7284
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 630-484-1577
  • Fax:
Mailing address:
  • Phone: 630-484-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.011845
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number036-156782
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: