FAZL KHADEMI

PEORIA, IL
NPI1740992577
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-12-23
Last Update Date2023-03-30
Business Address
FAZL KHADEMI
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2000
Mailing Address
FAZL KHADEMI
5817 W CHERRY CT
VISALIA, CA 93277-8873
Phone number: 847-313-5740