Frederick John Fagan, O.D.

NPI #1710153069 in Northlake, Illinois

Provider Information

NPI Number: 1710153069
Entity Type: Individual
Name: Frederick John Fagan, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: May 7, 2008
Last Updated: May 7, 2008

Practice Location

Address: 141 W NORTH AVE
City: Northlake
State: Illinois
ZIP Code: 60164-2322
Phone: (708) 492-1425

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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