Provider Demographics
NPI:1508931767
Name:FEERST, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FEERST
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 1:605 W CENTRAL RD
Mailing Address - Street 2:#100
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2377
Mailing Address - Country:US
Mailing Address - Phone:847-590-8100
Mailing Address - Fax:847-394-8505
Practice Address - Street 1:605 W CENTRAL RD
Practice Address - Street 2:#100
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2377
Practice Address - Country:US
Practice Address - Phone:847-590-8100
Practice Address - Fax:847-394-8505
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069659207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036069659Medicaid
IL31604292OtherBCBS
IL036069659Medicaid
IL31604292OtherBCBS