Individual
DR. LYNN A FESENMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
28375 DAVIS PKWY, SUITE 901, WARRENVILLE, IL 60555-3030
(630) 653-4240
(630) 225-4033
Mailing address
28375 DAVIS PKWY, SUITE 901, WARRENVILLE, IL 60555-3030
(630) 653-4240
(630) 225-4033
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-096209
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096209
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147210
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/11/2006
Last updated
04/22/2013
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