Individual
BRIAN MICHAEL FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
JOLIET RADIOLOGICAL SERVICES CORP PROVENA ST. JOESPH ME, 333 N MADISON ST, JOLIET, IL 60435
(815) 741-7213
(815) 741-7591
Mailing address
836 FORNHAM LN, WHEATON, IL 60187
(630) 681-9927
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36107817
IL
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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