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Individual

DR. TAIWO M FASEHUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3625 MUNICIPAL DR, MCHENRY, IL 60050-5434
(815) 385-8560
(815) 385-8568
Mailing address
3625 MUNICIPAL DR, MCHENRY, IL 60050-5434
(815) 385-8560
(815) 385-8568

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036087368
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036087368
IL
Enumeration date
06/25/2006
Last updated
04/29/2011
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