Healthcare Provider Details

I. General information

NPI: 1376756791
Provider Name (Legal Business Name): DENNIS JOHN MCFARLAND PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19815 GOVERNORS HWY SUITE 2
FLOSSMOOR IL
60422-4385
US

IV. Provider business mailing address

19815 GOVERNORS HWY SUITE 2
FLOSSMOOR IL
60422-4385
US

V. Phone/Fax

Practice location:
  • Phone: 708-957-7468
  • Fax: 708-957-7471
Mailing address:
  • Phone: 708-957-7468
  • Fax: 708-957-7471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: