Provider / Organization | NPI | Date Certified |
---|---|---|
MARIE FEFFERMAN | 1760002877 | 2020-06-27 |
Marie Fefferman is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1760002877. Registration indicates Marie Fefferman is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Surgery) (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians)
Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
Entity Type | Individual |
Provider Name | Marie Fefferman MD |
Practice Office Address | 5841 S MARYLAND AVE # 6040 CHICAGO, IL US |
Practice Office Telephone | 7737022500 |
Mailing Address | 180 HARVESTER DR STE 110 BURR RIDGE, IL 605276686 US |
Business Telephone | 7737021150 |
Code | Practice | License No State |
---|---|---|
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
208600000X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | 125.076631
IL |