Individual
DR. SAM FAYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 N PRAIRIE ST, GALESBURG, IL 61401-4617
(309) 344-7546
(309) 342-9946
Mailing address
201 N PRAIRIE ST, GALESBURG, IL 61401-4617
(309) 344-7546
(309) 342-9946
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036090128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04806986
BCBS
IL
05
—
371354426
—
IL
Enumeration date
09/01/2006
Last updated
08/04/2010
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