| Fairview Family Practice | |
|
412 63rd St Downers Grove IL 60516-2000 | |
| (630) 719-5472 | |
| (630) 719-5466 |
| Full Name | Fairview Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 412 63rd St, Downers Grove, Illinois |
| Authorized Official Name and Position | Ruby Mann (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 6308566884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Family Practice 412 63rd St Ste 103 Downers Grove IL 60516-2000 Ph: (630) 719-5472 | Fairview Family Practice 412 63rd St Downers Grove IL 60516-2000 Ph: (630) 719-5472 |
| NPI Number | 1871538603 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 06/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871538603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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