Shairoz A Fazal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

047932457 Issued in IL

Practice address

811 E.Butterfield Road Ste 111
Wheaton, IL 60187

Phone

(630) 480-8591

Fax

(630) 480-8595

NPI assigned

May 7, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487867768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 BUTTERFIELD RD STE 111",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878602",
            "telephone_number": "630-480-8591",
            "fax_number": "630-480-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E.BUTTERFIELD ROAD STE 111",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60187",
            "telephone_number": "630-480-8591",
            "fax_number": "630-480-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZAL",
        "first_name": "SHAIROZ",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "047932457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "204953491",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Farrow, SLP
• Mopelola O Fatuga
• Thomas Christian Favale Jr., DVM, LSW
• Izabel M Favela, MA
• Anna Marie Faveron, RN
• Joan L Fefferman, LCPC CADC
• Daisy M Felarca, M.D.
• Donna Lynn Feltz, OTR/L
• Kathryn Femiano
• Ashley Feneran, D.O.

• Optometrist in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.