Provider Demographics
NPI:1043294101
Name:FARKAS, DAVID ERIC (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ERIC
Last Name:FARKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3043
Mailing Address - Street 2:MEA - AEA KENOSH SC
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-3043
Mailing Address - Country:US
Mailing Address - Phone:630-734-0200
Mailing Address - Fax:630-734-1560
Practice Address - Street 1:10400 75TH ST
Practice Address - Street 2:AURORA MEDICAL CENTER
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7884
Practice Address - Country:US
Practice Address - Phone:262-697-7000
Practice Address - Fax:630-734-1560
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32565020207P00000X
NMMD2014-0811207P00000X
UT8921077-1205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31759700Medicaid
WI0002Medicare ID - Type Unspecified
WI31759700Medicaid