Fagan, Brian J

Fagan, Brian J is an sole proprietor health care provider with primary practice located at 310 W Chicago Ave , Chicago IL 60654-5106. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Fagan, Brian J can be contacted via phone (312) 943-6545.

Contact Information

Primary practice address
310 W Chicago Ave Chicago IL 60654-5106
Phone: (312) 943-6545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1669013843
LBN Legal business name Fagan, Brian J
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2019
Last updated May 14th, 2022 - about 3 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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