Individual
DR. MANDANA FAGHANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 SUPERIOR ST STE 101, MELROSE PARK, IL 60160-4100
(708) 344-2161
Mailing address
1008 PLEASANT ST, APT# 1A, OAK PARK, IL 60302-3059
(708) 567-7999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125054453
IL
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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