Most Relevant Information
Provider Data
| NPI Number: | 1003291279 |
| Provider Name: | FADEL AHMED BOFARRAG MD, MPH |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 2015014044 |
Most Important Dates
| Enumeration Date: | 07/29/2015 |
| Last Updated: | 06/06/2024 |
Provider Practice Location
701 N 1ST ST STE D434
SPRINGFIELD
IL
627023757
Practice Location Phone/Fax
| Phone: | 2175458000 |
| Fax: | 2175457063 |
Provider Mailing Location
PO BOX 19636
SPRINGFIELD
IL
627949636
Provider Mailing Phone/Fax
| Phone: | 2175458000 |
| Fax: | 2175457063 |
Suggested EMR
Internist EMR