Mary C Fairchild is a Clinical in Rockford, Illinois. Mary C Fairchild practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary C Fairchild is 1588771265. The last update date is 2019-09-23.
Mary C Fairchild's current location address is 2618 Cerro Vista Dr, Rockford, Illinois. You can contact this provider via phone number 8155206676 and fax number 8667249612. The mailing address for Mary C Fairchild is 2618 Cerro Vista Dr, Rockford, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary C Fairchild |
|---|---|
| Address | 2618 Cerro Vista Dr, Rockford, Illinois |
| Phone Number | 8155206676 |
| Fax Number | 8667249612 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1588771265 |
|---|---|
| Provider Enumeration Date | 2006-08-25 |
| Last Updated Date | 2019-09-23 |
Provider Mailing Address Detail
| Address | 2618 Cerro Vista Dr |
|---|---|
| City | Rockford |
| State | Illinois (IL) |
| Post Code | 611071008 |
| Phone Number | 8155206676 |
| Fax Number | 8667249612 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 149.010948 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 242733 | COMPSYCH CORP | ||
| 10132126 | IL | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mary C Fairchild by the Centers for Medicare & Medicaid Services?
The Mary C Fairchild has been issued the NPI (National Provider Identifier) 1588771265, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Mary C Fairchild's facilities are geographically located?
The facilities of Mary C Fairchild are physically situated at the following location: 2618 Cerro Vista Dr, Rockford, IL, 611071008.
What is Mary C Fairchild's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mary C Fairchild is Clinical, and the taxonomy classification code that categorizes this area of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1588771265 to Mary C Fairchild?
The Centers for Medicare & Medicaid Services assigned the 1588771265 to Mary C Fairchild on 2006-08-25.
When was the information pertaining to Mary C Fairchild most recently updated or revised?
The details related to Mary C Fairchild, including its address, specialty, and other relevant information, were last updated or revised on 2019-09-23.
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