Fairbanks, LLC
NPI #1619476405 in Long Grove, Illinois
Provider Information
- NPI Number
- 1619476405
- Entity Type
- Organization
- Organization Name
- Fairbanks, LLC
- Primary Specialty
- Specialist
- Enumeration Date
- Feb 7, 2018
- Last Updated
- Feb 7, 2018
Practice Location
- Address
- 3880 SALEM LAKE DR STE A
- City
- Long Grove
- State
- Illinois
- ZIP Code
- 60047-5292
- Phone
- (312) 321-1225
Authorized Official
- Name
- LISA CARNES
- Title
- PRINCIPAL
- Phone
- (312) 450-6382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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