Fasula, Kimberly

Fasula, Kimberly is an sole proprietor health care provider with primary practice located at 836 W Wellington Ave , Chicago IL 60657-5147. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Fasula, Kimberly can be contacted via phone (773) 474-6896.

Contact Information

Primary practice address
836 W Wellington Ave Chicago IL 60657-5147
Phone: (773) 474-6896
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 020009530 Illinois

Profile Details

NPI number 1548866916
LBN Legal business name Fasula, Kimberly
Credentials RDH, MS, MPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 9th, 2020
Last updated Dec 9th, 2020 - about 5 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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