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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

NPI # 1659538270
LBN Legal business name EDWARD J FESCO MD SC
Authorized official EDWARD FESCO - (SOLO PRACTIONER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/21/2008
Last updated 05/21/2008 - About 18 years ago
Identifiers
IL License # 036034820
IL Medicaid 036034820
IL Other 05000151 BC & BS
IL Other 021757686 RR MED
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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