Diane W Fondriest, MD

NPI #1568457554 in Lake Forest, Illinois

Provider Information

NPI Number: 1568457554
Entity Type: Individual
Name: Diane W Fondriest, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: MD
Enumeration Date: Sep 15, 2005
Last Updated: Apr 18, 2024

Practice Location

Address: 900 N WESTMORELAND RD
Address 2: SUITE 106
City: Lake Forest
State: Illinois
ZIP Code: 60045-1674
Phone: (847) 615-4654

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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