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General NPI Number Information
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NPI Number | 1235329384
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Entity Type | Individual
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Provider Name | FAYEZ MEKHAEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 1311 BUTTERFIELD RD STE 306
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5666
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Country | US
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Telephone | 630-445-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 MARK CIR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-4915
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36118957
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License Number State | IL
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