Fenton, Gregory Lucien

Fenton, Gregory Lucien is an individual health care provider with primary practice located at 2015 N Main St , Wheaton IL 60187-3190. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Fenton, Gregory Lucien can be contacted via phone (630) 668-8250.

Contact Information

Primary practice address
2015 N Main St Wheaton IL 60187-3190
Phone: (630) 668-8250
Fax: (630) 668-8916
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MT185909 Pennsylvania
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036124435 Illinois

Profile Details

NPI number 1114136959
LBN Legal business name Fenton, Gregory Lucien
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Oct 5th, 2022 - about 3 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 1114136959 NPPES
Illinois Other 313130004 MEDICARE
Illinois MEDICAID 036124435 MEDICARE

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