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Contact Information

EDWARD J FESCO MD SC
206 MARQUETTE ST
ROOM 206
LASALLE, IL61301
 Phone: 815-223-3616
 Fax: 815-223-0550
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EDWARD J FESCO MD SC · (Female)

NPI # 1659538270
Status Active
Credentials
Entity Individual
Enumeration date 05/21/2008
Last updated 05/21/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 036034820
  • IL Medicaid 036034820
  • IL Other 05000151 BC & BS
  • IL Other 021757686 RR MED
Hospital affiliation(s) Not Available
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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