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Individual
MR. SEAN FADALE
Active
Individual
MR. SEAN FADALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70014050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROVIDER #
IL
01
—
203
BLUE CROSS PROVIDER #
IL
01
—
4117
HAMP PROVIDER #
IL
01
—
7216
PERSONALCARE PROVIDER #
IL
Enumeration date
08/31/2007
Last updated
08/31/2007
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