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General NPI Number Information
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NPI Number | 1033555388
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Entity Type | Individual
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Provider Name | VICTORIA O. FADIYA DNP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 9405 BORMET DR STE 10
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City | MOKENA
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State | IL
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Zip | 60448-7400
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Country | US
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Telephone | 708-481-0095
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Fax | 866-299-8890
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Provider Business Mailing Address
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Address Line | 9405 BORMET DR STE 10
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City | MOKENA
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State | IL
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Zip | 60448-7400
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Country | US
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Telephone | 708-481-0095
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Fax | 866-299-8890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 277000226
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209009857
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License Number State | IL
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