Dr. Mark Andrew Fenlon
Foot & Ankle Surgery
12620 S Harlem Ave
Palos Heights
, Illinois 60463-1428
Dr. Mark Andrew Fenlon
Foot & Ankle Surgery
12620 S Harlem Ave
Palos Heights
, Illinois 60463-1428
(708) 361-3748
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Dr. Mark Andrew Fenlon
- 12620 S Harlem Ave
- Palos Heights, IL
- Zip : 60463-1428
- Fax : (708) 361-3748
- Phone : (708) 361-3338
Second Address
- Dr. Mark Andrew Fenlon
- 12620 S Harlem Ave
- Palos Heights, IL
- Zip : 60463-1428
- Fax : (708) 361-3748
- Phone : (708) 361-3338
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | 16-004799 | IL |
National Provider Identifier
| NPI | 1043341068 |
|---|---|
| Provider Name | Dr. Mark Andrew Fenlon |
| First Address | Palos Heights, IL 60463-1428 |
| Second Address | Palos Heights, IL 60463-1428 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U56345 | (02) | IL |
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.