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NPI Code Detail

MEDICARE: DR. ATIF FAKHRUDDIN MD

MEDICARE: DR. ATIF FAKHRUDDIN MD
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
1207RN0300XNephrology Physician36116035IL

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 : 1952349516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ATIF FAKHRUDDIN MD
Provider Business Mailing Address
First Line : 28594 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1285
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 80 TEMPLETON DR
Second Line :
City : OSWEGO
State : IL
Zip : 60543-7000
Country : US
Telephone Number : 630-554-3456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 06/17/2025

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