Individual
ERIN ELIZABETH FANCHER GAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
411 E BROADWAY, TRENTON, IL 62293-1663
(618) 224-7000
(618) 224-7750
Mailing address
411 E BROADWAY, TRENTON, IL 62293-1663
(618) 224-7000
(618) 224-7750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036113295
IL
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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