Individual
DR. PHILIP CYRUS FANAPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-1900
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-1900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036139602
IL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
036139602
IL
Other
Enumeration date
04/27/2011
Last updated
07/10/2024
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