Fagan, Kevin J

Fagan, Kevin J is an individual health care provider with primary practice located at 71 W 156Th St Suite 308, Harvey IL 60426-4260. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Fagan, Kevin J can be contacted via phone (708) 331-6617.

Contact Information

Primary practice address
71 W 156Th St Suite 308 Harvey IL 60426-4260
Phone: (708) 331-6617
Fax: (708) 331-7957
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036068721 Illinois

Profile Details

NPI number 1427061068
LBN Legal business name Fagan, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Feb 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427061068 NPPES
Illinois Other F400415105 MEDICARE
Illinois MEDICAID 036068721 MEDICARE

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