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Individual

MRS. CANAN FAIRHURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
484 W BOUGHTON RD, BOLINGBROOK, IL 60440-2398
(630) 296-0942
Mailing address
484 W BOUGHTON RD, BOLINGBROOK, IL 60440-2398
(630) 296-0942

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
3002264
IL

Other

Enumeration date
08/22/2022
Last updated
08/22/2022
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