Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
FREDERICK JOHN FAGAN, O.D.
Active Sole ProprietorFREDERICK JOHN FAGAN, O.D. is a Optometrist healthcare provider located in NORTHLAKE, Illinois. NPI 1710153069 is currently active in the NPPES registry. Verify at CMS.
Optometrist · NORTHLAKE, IL
Registration Details
- NPI Number
- 1710153069
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 7, 2008 (18.25604541975 yrs)
- Last Updated
- May 7, 2008
- License
-
046006959 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
141 W NORTH AVENORTHLAKE, IL, 601642322Browse IL providers · Browse ZIP 60164
- Phone
- 7084921425
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in NORTHLAKE, IL
| Name | Credential | NPI |
|---|---|---|
| DIANE G FORECKI | OD | 1306004148 |
| DR. VISHAL K PATEL | O.D. | 1427499797 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.