Healthcare Provider Details

I. General information

NPI: 1821176850
Provider Name (Legal Business Name): MIGUEL FAROLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S WASHINGTON STREET EDWARD HOSPITAL
NAPERVILLE IL
60566-7060
US

IV. Provider business mailing address

DEPARTMENT 4387
CAROL STREAM IL
60122-4387
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-0450
  • Fax: 630-527-3911
Mailing address:
  • Phone: 630-355-0450
  • Fax: 630-527-3911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number036078834
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036078834
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: