Individual
DR. DAVID L MCFADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 MADISON ST STE 303, JOLIET, IL 60435-6576
(815) 744-1770
Mailing address
10660 W 143RD ST STE B, ORLAND PARK, IL 60462-1989
(708) 349-0055
(708) 460-8031
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
042008047
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087527
—
IL
01
—
390004585
PALMETTO RR MEDICARE
IL
01
—
9908151
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/12/2006
Last updated
05/18/2008
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