Fardon, David Favreau

Fardon, David Favreau is an individual health care provider with primary practice located at 1611 W Harrison St Ste 400, Chicago IL 60612-3841. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Fardon, David Favreau can be contacted via phone (312) 243-4244.

Contact Information

Primary practice address
1611 W Harrison St Ste 400 Chicago IL 60612-3841
Phone: (312) 243-4244
Fax: (312) 942-1517
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036118859 Illinois

Profile Details

NPI number 1811964679
LBN Legal business name Fardon, David Favreau
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Nov 23rd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811964679 NPPES
Illinois MEDICAID 036118859
Illinois Other 207073
Illinois Other 1633878
Illinois Other 207067
Illinois Other 4457824

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