Individual
STEPHANIE FAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
425 OGDEN AVE, DOWNERS GROVE, IL 60515-3066
(630) 506-5553
Mailing address
425 OGDEN AVE, DOWNERS GROVE, IL 60515-3066
(630) 506-5553
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021907
IL
Other
Enumeration date
08/29/2020
Last updated
11/12/2020
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