Individual
MAYA NOELLE FAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE STE MC7082, CHICAGO, IL 60637-1465
(773) 702-0309
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.074646
IL
208000000X
Pediatrics Physician
Primary
125.074646
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2019
Last updated
06/07/2019
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