Fahey, Mandi J
Fahey, Mandi J is an sole proprietor health care provider with primary practice located at 4905 S Inglewood Rd , Rogers AR 72758-9011. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Fahey, Mandi J can be contacted via phone (630) 770-9510.Contact Information
Primary practice address
4905 S Inglewood Rd
Rogers AR 72758-9011
Phone: (630) 770-9510
Fax: (479) 289-5129
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 056006980 | Illinois |
Profile Details
| NPI number | 1689750689 |
|---|---|
| LBN Legal business name | Fahey, Mandi J |
| Credentials | MS, OTR/L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Aug 20th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689750689 | NPPES |
| Arkansas | Other | OTR2510 | ARKANSAS STATE MED BOARD |
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