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Individual

DR. NATHAN JOSEPH FANTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
396 REMINGTON BLVD STE 130, BOLINGBROOK, IL 60440-4309
(630) 759-1248
Mailing address
1 ERIE CT, SUITE 7120, OAK PARK, IL 60302-2566
(708) 848-4662
(708) 848-4695

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036.128499
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036128499
IL
Enumeration date
07/23/2008
Last updated
03/16/2021
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