Individual
MR. MARLON FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6058 W FULLERTON AVE, CHICAGO, IL 60639-2243
(773) 828-6045
(773) 473-4104
Mailing address
6058 W FULLERTON AVE, CHICAGO, IL 60639-2243
(773) 828-6045
(773) 473-4104
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
10138PT
IL
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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