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Individual

HENRY FAJARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
550 W FRONTAGE RD STE 2415, NORTHFIELD, IL 60093-1212
(877) 787-3422
Mailing address
550 FRONTAGE RD STE 2415, NORTHFIELD, IL 60093
(877) 787-3422

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
070014005
IL
225100000X
Physical Therapist
Primary

Other

Enumeration date
07/27/2011
Last updated
10/25/2013
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