Individual
LORI M FABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
301 N 8TH ST # 5B, SPRINGFIELD, IL 62701-1041
(217) 545-8000
(217) 545-0253
Mailing address
PO BOX 19662, SPRINGFIELD, IL 62794-9662
(217) 545-8000
(217) 545-0253
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000451
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147-000451
STATE LICENSE
IL
Enumeration date
02/23/2006
Last updated
10/21/2020
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