Dr. Fred M Fitzpatrick
Pediatric Dentist
690 N Il Route 31
Crystal Lake
, Illinois 60012-3790
Dr. Fred M Fitzpatrick
Pediatric Dentist
690 N Il Route 31
Crystal Lake
, Illinois 60012-3790
(815) 459-9230
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Fred M Fitzpatrick
- 651 Woodland Dr
- Crystal Lake, IL
- Zip : 60014-5214
- Phone : (815) 459-9230
Second Address
- Dr. Fred M Fitzpatrick
- 690 N Il Route 31
- Crystal Lake, IL
- Zip : 60012-3790
- Phone : (815) 459-2727
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | A13595 | IL |
National Provider Identifier
| NPI | 1063526796 |
|---|---|
| Provider Name | Dr. Fred M Fitzpatrick |
| First Address | Crystal Lake, IL 60014-5214 |
| Second Address | Crystal Lake, IL 60012-3790 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.