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Individual
JEANNA MARIE FASCIONE
Active
Individual
JEANNA MARIE FASCIONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
135000706
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36.003645
OH
390200000X
Student in an Organized Health Care Education/Training Program
135000706
IL
Other
Enumeration date
06/21/2010
Last updated
11/13/2017
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