Fassl, Michael R

Fassl, Michael R is an individual health care provider with primary practice located at 11600 S Kedzie Ave , Merrionette Park IL 60803-6307. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Fassl, Michael R can be contacted via phone (708) 272-4150.

Contact Information

Primary practice address
11600 S Kedzie Ave Merrionette Park IL 60803-6307
Phone: (708) 272-4150
Fax: (708) 229-0696
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-165936 Illinois

Profile Details

NPI number 1477173664
LBN Legal business name Fassl, Michael R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2020
Last updated Oct 11th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477173664 NPPES
Illinois Other 036-165936 LICENSE

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