Individual
DR. HOWARD CLARK FEDERER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2740 W FOSTER AVE, SUITE 213, CHICAGO, IL 60625-3500
(773) 293-4001
(773) 293-3203
Mailing address
2740 W FOSTER AVE STE 213, CHICAGO, IL 60625-3532
(773) 293-4001
(773) 293-3203
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036072388
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-072388
—
IL
01
—
406120103
PTAN
—
Enumeration date
07/21/2006
Last updated
03/02/2021
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