Provider Demographics
NPI:1972867976
Name:ASIEDU-FALKNER, CANDACE MERCY (MD)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:MERCY
Last Name:ASIEDU-FALKNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:MERCY
Other - Last Name:ASIEDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 ERIE CT
Mailing Address - Street 2:SUITE 6160
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2566
Mailing Address - Country:US
Mailing Address - Phone:708-763-1490
Mailing Address - Fax:708-763-7232
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:SUITE 6160
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2566
Practice Address - Country:US
Practice Address - Phone:708-763-1490
Practice Address - Fax:708-763-7232
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125061964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine