Organization
DALE W. FABER, LCSW, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE W FABER LCSW, PH.D. M.DIV. (OWNER)
(630) 926-4873
Entity
Organization
Contact information
Practice address
1035 GROVE ST, DOWNERS GROVE, IL 60515-4636
(630) 926-4873
(630) 852-6335
Mailing address
1035 GROVE ST, DOWNERS GROVE, IL 60515-4636
(630) 926-4873
(630) 852-6335
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
149-008480
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
149-008480
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2223316
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/28/2010
Last updated
07/09/2013
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