Organization
DEERBROOK MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRA FENTON DO (OWNER)
(847) 367-7340
Entity
Organization
Contact information
Practice address
1870 W WINCHESTER RD STE 112, LIBERTYVILLE, IL 60048-5365
(847) 224-0165
(847) 247-2840
Mailing address
1870 W WINCHESTER RD STE 112, LIBERTYVILLE, IL 60048-5365
(847) 224-0165
(847) 247-2840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36110464
IL
207RR0500X
Rheumatology Physician
36058893
IL
363AM0700X
Medical Physician Assistant
085001035
IL
Other
Enumeration date
08/17/2006
Last updated
04/26/2024
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