Healthcare Provider Details
I. General information
NPI: 1033240932
Provider Name (Legal Business Name): FERMINA VENTURA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1640 N ARLINGTON HEIGHTS RD SUITE 110
ARLINGTON HEIGHTS IL
60004-3985
US
IV. Provider business mailing address
1640 N ARLINGTON HEIGHTS RD SUITE 110
ARLINGTON HEIGHTS IL
60004-3985
US
V. Phone/Fax
- Phone: 847-255-7400
- Fax: 847-398-4585
- Phone: 847-255-7400
- Fax: 847-398-4585
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: