Provider Demographics
NPI:1770888695
Name:ATHER, FAYAZ SYED (DC)
Entity type:Individual
Prefix:DR
First Name:FAYAZ
Middle Name:SYED
Last Name:ATHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W WASHINGTON BLVD.
Mailing Address - Street 2:STE 4
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607
Mailing Address - Country:US
Mailing Address - Phone:312-850-2225
Mailing Address - Fax:312-850-2226
Practice Address - Street 1:1000 W WASHLINGTON BLVD
Practice Address - Street 2:STE 4
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607
Practice Address - Country:US
Practice Address - Phone:312-850-2225
Practice Address - Fax:312-850-2226
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor