Dr Keith Lewis Fabrique, MD is a
Preventive Medicine - Occupational Medicine physician based in Decatur, Illinois. Dr Keith Lewis Fabrique is licensed to practice in Illinois (license number 036050458) and his current practice location is 1750 E Lake Shore Dr, Lower Level, Decatur, Illinois. He can be reached at his office (for appointments etc.) via phone at
(217) 425-2732.
NPI number for Dr Keith Lewis Fabrique is 1225196710 and his current mailing address is 1750 E Lake Shore Dr, Lower Level, Decatur, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225196710.
Physician's Profile
| Full Name | Dr Keith Lewis Fabrique |
|---|
| Gender | Male |
|---|
| Speciality | Preventive Medicine - Occupational Medicine |
|---|
| Location | 1750 E Lake Shore Dr, Decatur, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1225196710
- Provider Enumeration Date: 12/05/2006
- Last Update Date: 12/29/2021
Medical Identifiers
Medical identifiers for Dr Keith Lewis Fabrique such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1225196710 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 036050458 (Illinois) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 036050458 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith Lewis Fabrique is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Keith Lewis Fabrique, MD 1750 E Lake Shore Dr, Lower Level, Decatur, IL 62521 Ph: (217) 425-2732 | Dr Keith Lewis Fabrique, MD 1750 E Lake Shore Dr, Lower Level, Decatur, IL 62521 Ph: (217) 425-2732 |
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