Individual
FACUNDO BENITO DOVALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20660 CATON FARM RD, UNIT F, CREST HILL, IL 60403-1201
(815) 714-5430
(815) 714-5369
Mailing address
20660 CATON FARM RD, UNIT F, CREST HILL, IL 60403-1201
(815) 714-5430
(815) 714-5369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085934
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633171
BCBS
IL
05
—
036085934 2
—
IL
05
—
036085934 3
—
IL
01
—
1620404
BCBS
IL
01
—
1635426
BCBS
IL
Enumeration date
03/16/2007
Last updated
04/14/2022
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