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NPI Code Detail

MEDICARE: DR. FAIROUZ CARPIZO CODINA M.D.

MEDICARE: DR. FAIROUZ CARPIZO CODINA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036129095IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841580438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FAIROUZ CARPIZO CODINA M.D.
Provider Business Mailing Address
First Line : 400 E RANDOLPH ST
Second Line : UNIT 3207
City : CHICAGO
State : IL
Zip : 60601-7329
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1423 CHICAGO RD
Second Line : UNIT 3207
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-3400
Country : US
Telephone Number : 708-756-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2011
Last Update Date : 09/21/2012

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