Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | IL | |
N | 1223E0200X | Endodontist | IL |
NPI | 1124182894 |
---|---|
Provider Name | Dr. Maria J. Fournier |
First Address | Arlington Heights, IL 60004-7709 |
Second Address | Arlington Heights, IL 60004-7709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |