Individual
SUSAN M ICHELLE FANAPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
120 N. OAK STREET, HINSDALE, IL 60521
(630) 856-9000
Mailing address
1200 HARGER RD STE 408, OAK BROOK, IL 60523-1818
(630) 472-8800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036105985
IL
Other
Enumeration date
08/02/2005
Last updated
07/31/2023
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