Organization
DAVID L. MCFADDEN,M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LARRY MCFADDEN M.D. (NEPHROLOGIST)
18159425813
Entity
Organization
Contact information
Practice address
3709 VILLAGE DR, HAZEL CREST, IL 60429-2444
(815) 942-5813
Mailing address
3709 VILLAGE DR, HAZEL CREST, IL 60429-2444
(815) 942-5813
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036087527
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087527
—
IL
01
—
214640
MEDICARE
IL
Enumeration date
07/14/2008
Last updated
07/14/2008
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