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1740992577
FAZL KHADEMI
PEORIA, IL
NPI
1740992577
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-12-23
Last Update Date
2023-03-30
Business Address
FAZL KHADEMI
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2000
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Mailing Address
FAZL KHADEMI
5817 W CHERRY CT
VISALIA, CA 93277-8873
Phone number: 847-313-5740
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