Fireside, David

Fireside, David is an sole proprietor health care provider with primary practice located at 108 Wilmot Rd , Deerfield IL 60015-5145. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Fireside, David can be contacted via phone (847) 580-0002.

Contact Information

Primary practice address
108 Wilmot Rd Deerfield IL 60015-5145
Phone: (847) 580-0002
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 227.009223 Illinois

Profile Details

NPI number 1134526171
LBN Legal business name Fireside, David
Credentials LCMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2014
Last updated Nov 19th, 2014 - about 11 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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