JOHN KENNETH FAVALE

EVANSTON, IL
NPI1821180696
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019018464)
Enumeration Date2006-09-29
Last Update Date2007-07-08
Business Address
Dr. JOHN KENNETH FAVALE
1604 CHICAGO AVE
EVANSTON, IL 60201-6017
Phone number: 847-866-8844
Mailing Address
Dr. JOHN KENNETH FAVALE
404 ADELPHIA AVE
LAKE BLUFF, IL 60044-1502
Phone number: 847-295-6979