Fandohan, Doris

Fandohan, Doris is an sole proprietor health care provider with primary practice located at 3046 127Th St , Blue Island IL 60406-1827. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fandohan, Doris can be contacted via phone (708) 377-7920.

Contact Information

Primary practice address
3046 127Th St Blue Island IL 60406-1827
Phone: (708) 377-7920
Fax: (708) 930-0414
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71008752A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209019405 Illinois

Profile Details

NPI number 1679038186
LBN Legal business name Fandohan, Doris
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 8th, 2019
Last updated Apr 20th, 2020 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1679038186 NPPES
Indiana Other 71008752A NURSE PRACTITIONER LICENSE NUMBER

Popular Providers