Individual
BRIAN FONDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.012603
IL
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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