Individual
DR. FREDERIC MARK ETTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7126 N LINCOLN AVE, LINCOLNWOOD, IL 60712-2234
(847) 733-2229
(847) 733-1528
Mailing address
7126 N LINCOLN AVE, LINCOLNWOOD, IL 60712-2234
(847) 733-2229
(847) 733-1528
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0136053752
IL
Other
Enumeration date
12/20/2006
Last updated
11/15/2016
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