Individual
DARRYL FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 FRANKLIN AVE STE 210, NORMAL, IL 61761-3588
(309) 452-1193
(309) 452-1349
Mailing address
1300 FRANKLIN AVE STE 210, NORMAL, IL 61761-3588
(309) 452-1193
(309) 452-1349
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036108683
IL
Other
Enumeration date
06/01/2006
Last updated
10/10/2012
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