Provider Demographics
NPI:1669044160
Name:ZITOUNI, FATIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:ZITOUNI
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 1:8450 S OCTAVIA AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1725
Mailing Address - Country:US
Mailing Address - Phone:773-703-5407
Mailing Address - Fax:
Practice Address - Street 1:835 S WOLCOTT AVE UNIT E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3748
Practice Address - Country:US
Practice Address - Phone:312-996-7420
Practice Address - Fax:312-413-8485
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125078928207R00000X
IL125.0789282083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL320351299Medicaid