Individual
AMANDA M FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 DEPOT ST, GARDNER, IL 60424-9441
(815) 557-0980
Mailing address
684 CIRCLE DR, COAL CITY, IL 60416-4003
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
000828467
IL
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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