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Doris Fandohan, NURSEPRACTITIONER
Family Nurse Practitioner in Blue Island, Illinois
NPI 1679038186

Doris Fandohan is a Family Nurse Practitioner based in Chicago, IL and is specialized in Family. Doris Fandohan practices in Blue Island, IL and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Doris Fandohan is 1679038186 and holds a License No. 71008752A (Illinois).

The current practice location address for Doris Fandohan is 3046 127Th St, Blue Island, IL and can be reached out via phone at 708-377-7920 and via fax at 708-930-0414.

Location: 3046 127Th St, Blue Island, IL, 60603-2420
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Provider Profile Details
NPI Number
1679038186
Provider Name
Doris Fandohan
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
3046 127Th St, Blue Island, IL, 60603-2420
Phone Number
708-377-7920
Fax Number
708-930-0414
Provider Enumeration Date
02/08/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
71008752A 01 IN NURSE PRACTITIONER LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
3046 127Th St
City
State
Zip
60406-1827
Phone Number
708-377-7920
Fax Number
708-930-0414
person
Provider Business Mailing Address Details
Address
3046 127Th St
City
State
Zip
60406-1827
Phone Number
708-377-7920
Fax Number
708-930-0414
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71008752A (Indiana)
Definition
Definition to come...
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