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Marie Fefferman

NPI Registration Record

Provider / OrganizationNPIDate Certified
MARIE FEFFERMAN17600028772020-06-27
Entity TypeIndividual
Provider Name Marie Fefferman MD
Practice Office Address5841 S MARYLAND AVE # 6040
CHICAGO, IL US
Practice Office Telephone7737022500
Mailing Address180 HARVESTER DR STE 110
BURR RIDGE, IL 605276686 US
Business Telephone7737021150
HPT Codes
CodeLicense NoState
390200000X
208600000X PRIMARY125.076631 IL
OPI Codes

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