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NPI Code Detail

MEDICARE: PAUL G FAINE M.D.

MEDICARE: PAUL G FAINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036-094361IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033136577
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL G FAINE M.D.
Provider Business Mailing Address
First Line : 440 RIDGE AVE
Second Line :
City : CLARENDON HILLS
State : IL
Zip : 60514-2706
Country : US
Telephone Number : 630-920-0946
Fax Number :
Provider Business Practice Location Address
First Line : 3249 OAK PARK AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-3429
Country : US
Telephone Number : 708-783-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 04/02/2026

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