| Doctor Name: | DR. FAHED NAZEM ELCHAMI |
| NPI Number: | 1013300839 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 65 P88839 |
| Business Practice Address: | 711 W Ravinwoods Rd Peoria, IL - 616151353 |
| Business Phone Number: | 1309253401 |
| Business Fax Number: | |
| Mailing Address: | 711 W Ravinwoods Rd, PEORIA |
| State: | IL |
| Postal Code: | 61615 |
| Phone Number: | 1302534016 |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2015 |
| NPI Last Update Date: | 03/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 65 P88839 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |