Provider Demographics
NPI:1073863247
Name:FABER, MICHEAL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHEAL
Middle Name:JOHN
Last Name:FABER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14277 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1932
Mailing Address - Country:US
Mailing Address - Phone:708-403-3252
Mailing Address - Fax:708-403-3251
Practice Address - Street 1:14277 S. WOLD RD.
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-1932
Practice Address - Country:US
Practice Address - Phone:708-403-3252
Practice Address - Fax:708-430-3251
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.005556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor