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General NPI Number Information
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NPI Number | 1902477623
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Entity Type | Individual
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Provider Name | ABIGAIL FABER DCLINPSY
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Gender | Female
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Dates
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Enumeration Date | 07/03/2021
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 1552 S ROUTE 59 # 1027
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City | NAPERVILLE
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State | IL
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Zip | 60564-5941
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Country | US
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Telephone | 319-481-1203
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 W WRIGHTWOOD AVE APT I
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City | CHICAGO
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State | IL
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Zip | 60614-1140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.009591
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License Number State | IL
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