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Contact Information

JORGE E FERNALD, MD
7300 W COLLEGE DR
SUITE #101
PALOS HEIGHTS, IL60463
 Phone: 708-448-8470
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for JORGE E FERNALD · (Male)

NPI # 1912056326
Status Active
Credentials MD
Entity Individual
Enumeration date 01/09/2007
Last updated 08/23/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036-085526
  • IL License # 036-095526
  • IL Medicaid 036095526
  • IL Other F400488988 MEDICARE
Hospital affiliation(s)
  • PARIS COMMUNITY HOSPITAL - (Critical Access)
    721 E COURT STREET
    PARIS, IL 61944
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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