Individual
DAVID A FETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2626 WASHINGTON ST, WAUKEGAN, IL 60085-4917
(847) 599-9500
(847) 599-9485
Mailing address
2626 WASHINGTON ST, WAUKEGAN, IL 60085-4917
(847) 599-9500
(847) 599-9485
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036057645
IL
Other
Enumeration date
09/13/2005
Last updated
08/18/2010
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