Healthcare Provider Details

I. General information

NPI: 1730702564
Provider Name (Legal Business Name): KATHERINE ANNE FAVIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SPALDING DR STE 401
NAPERVILLE IL
60540-6560
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-369-7700
  • Fax: 630-717-0665
Mailing address:
  • Phone: 630-369-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036178347
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: