Fedie, Justin M

Fedie, Justin M is an individual health care provider with primary practice located at 555 E Townline Rd Ste 24 , Vernon Hills IL 60061-1552. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Fedie, Justin M can be contacted via phone (847) 573-0051.

Contact Information

Primary practice address
555 E Townline Rd Ste 24 Vernon Hills IL 60061-1552
Phone: (847) 573-0051
Fax: (847) 573-0345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10260024 Wisconsin

Profile Details

NPI number 1699705962
LBN Legal business name Fedie, Justin M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jul 21st, 2022 - about 2 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 1699705962 NPPES
Wisconsin MEDICAID 40442300
Wisconsin Other 0604410001

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