| Doctor Name: | MR. FAUSTINO FERNANDEZ |
| NPI Number: | 1023256732 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | |
| Business Practice Address: | 140 N County Line Rd Apt 123 Hinsdale, IL - 605213861 |
| Business Phone Number: | 6303255803 |
| Business Fax Number: | 6303255803 |
| Mailing Address: | 140 N. County Ln Rd, Apt 123 HINSDALE |
| State: | IL |
| Postal Code: | 60521 |
| Phone Number: | 6303255803 |
| Fax Number: | 6303255803 |
| NPI Enumeration Date: | 02/03/2009 |
| NPI Last Update Date: | 02/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |