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Individual

MR. DAVID FOWKES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ATC, MS, FF/PM

Contact information

Practice address
433 VINE AVE, HIGHLAND PARK, IL 60035-2044
(224) 765-2094
Mailing address
1137 SHARI LN, LIBERTYVILLE, IL 60048-2532

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
03/14/2006
Last updated
07/08/2007
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