Healthcare Provider Details
I. General information
NPI: 1063406825
Provider Name (Legal Business Name): REBECCA E MCFALL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2005
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4440 W 95TH ST
OAK LAWN IL
60453-2600
US
IV. Provider business mailing address
29373 NETWORK PL
CHICAGO IL
60673-1293
US
V. Phone/Fax
- Phone: 708-684-4094
- Fax: 708-684-5141
- Phone: 847-390-5900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036-112774 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0207X |
| Taxonomy | Pediatric Hematology & Oncology Physician |
| License Number | 036-112774 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: