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Organization
NEUROLOGY ASSOCIATES LTD.
Active
Organization
NEUROLOGY ASSOCIATES LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FAGAN MD (PRESIDENT)
(708) 331-6617
Entity
Organization
Contact information
Practice address
71 W 156TH ST, SUITE 308, HARVEY, IL 60426-4260
(708) 331-6617
(708) 331-7957
Mailing address
71 W 156TH ST, SUITE 308, HARVEY, IL 60426-4260
(708) 331-6617
(708) 331-7957
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042-07812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617846
BLUE CROSS PROVIDER NO.
—
01
—
042-07812
GROUP LICENSE NUMBER
IL
Enumeration date
08/14/2006
Last updated
08/22/2020
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