Individual
YEKATERINA FAYN
Active
Individual
YEKATERINA FAYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01069692A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036117305
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036117305
STATE LICENSE
IL
05
—
036117305
—
IL
01
—
1699934471
NPI NUMBER
IL
05
—
201025070
—
IN
01
—
336078451
CONTROLLED SUBSTANCE LICENSE
IL
01
—
F400434935
MEDICARE NUMBER
IL
Enumeration date
06/05/2008
Last updated
11/17/2023
Update your record
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