Individual
DR. GREGORY J FAHRENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
036062547
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021604007
BSIL
IL
01
—
0242720001
DME
IL
05
—
036062547
—
IL
01
—
131128300
US DEPT OF LABOR
—
01
—
1861475964
NPI
IL
01
—
200026425
RAILROAD MEDICARE
IL
Enumeration date
11/22/2005
Last updated
02/04/2015
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