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Individual

HSIEN TA FANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 SPALDING DR, SUITE 410, NAPERVILLE, IL 60540-6508
(630) 369-0780
(630) 369-0886
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036103303
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036103303
IL
01
1616108
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/17/2006
Last updated
04/28/2025
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