| Susan Fedinec, D.o. Llc | |
|
24600 W 127th St Bldg B Suite 340 Plainfield IL 60585-9502 | |
| (815) 676-2940 | |
| (815) 676-2942 |
| Full Name | Susan Fedinec, D.o. Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 24600 W 127th St, Plainfield, Illinois |
| Authorized Official Name and Position | Susan Marie Fedinec (OWNER) |
| Authorized Official Contact | 8156762940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Fedinec, D.o. Llc 24600 W 127th St Suite 340 Bldg B Plainfield IL 60585-9507 Ph: (815) 676-2940 | Susan Fedinec, D.o. Llc 24600 W 127th St Bldg B Suite 340 Plainfield IL 60585-9502 Ph: (815) 676-2940 |
| NPI Number | 1215007505 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 07/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215007505 | NPI | - | NPPES |
| 9932303 | Other | IL | BLUE CROSS BLUE SHIELD ID |
| 036 078573 | Other | IL | IL STATE LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036 078573 (Illinois) | Primary |
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