Faulk, David L

Faulk, David L is an individual health care provider with primary practice located at 1 E Countyline Rd , Sandwich IL 60548-2178. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Faulk, David L can be contacted via phone (815) 786-2722.

Contact Information

Primary practice address
1 E Countyline Rd Sandwich IL 60548-2178
Phone: (815) 786-2722
Fax: (815) 786-6840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 036 049209 Illinois

Profile Details

NPI number 1760475271
LBN Legal business name Faulk, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jan 9th, 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 1760475271 NPPES
Other 1921614 BC/BS
MEDICAID 036049209 BC/BS

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