Provider Demographics
NPI:1437307337
Name:FARIAS, CARLOS LUIS (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:LUIS
Last Name:FARIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3050 FINLEY RD STE 300B
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1369
Mailing Address - Country:US
Mailing Address - Phone:630-426-6018
Mailing Address - Fax:630-426-3703
Practice Address - Street 1:3050 FINLEY RD STE 300B
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1369
Practice Address - Country:US
Practice Address - Phone:630-426-6018
Practice Address - Fax:630-426-3703
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2022-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO1131762082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck