Faith Fann, RDH

Individual provider Active NPI Dental Hygienist · Christopher, IL

NPI 1003233909 · NPPES record last updated Mar 28, 2014

Key facts

NPI
1003233909
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
020014613 (IL)
Practice address
4241 Highway 14 West
Christopher, IL 62822
Phone
(618) 724-2401
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
020014613ILMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020014613 IL Yes

Addresses

Primary practice location

4241 Highway 14 West
Christopher, IL 62822

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401

Other providers in Christopher, IL

All providers in Christopher, IL · Dental Hygienist in Illinois

Sources for this page

Verify at the official NPI Registry.