Organization
FAGAN PSYCHOTHERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FAGAN (OWNER)
(312) 385-9620
Entity
Organization
Contact information
Practice address
2605 PRAIRIE AVE APT 18, EVANSTON, IL 60201-1496
(312) 385-9620
Mailing address
2605 PRAIRIE AVE APT 18, EVANSTON, IL 60201-1496
(312) 385-9620
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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