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MACIE J FAZAL
NPI 1083559603
Student in an Organized Health Care Education/Training Program in Mequon, WI

Active since April 21, 2026
12800 N LAKE SHORE DR, MEQUON, WI 53097(262) 243-5700 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Macie J Fazal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACIE J FAZAL (NPI 1083559603) is an individual student in an organized health care education/training program in Mequon, Wisconsin and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1083559603
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMACIE J FAZAL
Location Address12800 N LAKE SHORE DRMequon, WI 53097-2418
Mailing AddressN68w6976 Cleveland StCedarburg, WI 53012-1832
Phone(262) 243-5700
Sole ProprietorNo
Enumeration DateApril 21, 2026
NPPES CertifiedApril 21, 2026
✔ NPI 1083559603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X
12800 N LAKE SHORE DR, Mequon, WI 53097
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA ESSEX
Student in an Organized Health Care Education/Training Program
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 243-5700
LOIS HARRISON
Physical Therapist
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 243-4468
MISS MADELINE DALLMAN LAT
Specialist/Technologist (Athletic Trainer)
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 993-1669
MATTHEW PAUL GUINANE
Specialist/Technologist (Athletic Trainer)
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (641) 821-0508
KARA CLAUSSNER
Student in an Organized Health Care Education/Training Program
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 243-4537
DAVID PAUL KRUKEMYER ATC
Specialist/Technologist (Athletic Trainer)
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 243-2140
COURTNEY LEE MORSE
Student in an Organized Health Care Education/Training Program
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (630) 699-2751
DANIEL NELSON
Specialist/Technologist (Athletic Trainer)
12800 N LAKE SHORE DR
MEQUON, WI 53097
Ozaukee County (262) 243-2129

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Macie Fazal's NPI number?

The NPI number for Macie Fazal is 1083559603. It was assigned to this individual provider in the NPPES registry on April 21, 2026.

Where is Macie Fazal located?

Macie Fazal practices at 12800 N Lake Shore Dr, Mequon, WI 53097. The listed phone number is (262) 243-5700.

What is Macie Fazal's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Macie Fazal was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.