Provider Demographics
NPI:1386832830
Name:HADDADIN, FADIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:FADIA
Middle Name:J
Last Name:HADDADIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W CHICAGO AVE
Mailing Address - Street 2:STE F
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3261
Mailing Address - Country:US
Mailing Address - Phone:219-703-2583
Mailing Address - Fax:219-703-6749
Practice Address - Street 1:8141 KENNEDY AVENUE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1128
Practice Address - Country:US
Practice Address - Phone:219-838-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064123A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine