| Donald Fagerson Md Sc | |
|
1644 W Colonial Pkwy Inverness IL 60067-1207 | |
| (847) 358-1588 | |
| (847) 358-1542 |
| Full Name | Donald Fagerson Md Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1644 W Colonial Pkwy, Inverness, Illinois |
| Authorized Official Name and Position | Donald L Fagerson (PRESIDENT) |
| Authorized Official Contact | 8473581588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald Fagerson Md Sc 1644 W Colonial Pkwy Inverness IL 60067-1207 Ph: (847) 358-1588 | Donald Fagerson Md Sc 1644 W Colonial Pkwy Inverness IL 60067-1207 Ph: (847) 358-1588 |
| NPI Number | 1497877963 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 04/23/2015 |
| Medicare PECOS PAC ID | 6901865302 |
|---|---|
| Medicare Enrollment ID | O20041008001430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497877963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036-085741 (Illinois) | Primary |
| Provider Name | Donald Fagerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821110396 PECOS PAC ID: 9638138035 Enrollment ID: I20041013000215 |
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