IndividualActive
Amanda Fagan
NPI 1790664142 · Paramedic · Gardner, IL
Provider details
- NPI number
- 1790664142
- Entity type
- Individual
- Primary specialty
- ParamedicEmergency Medical Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 000828467 (IL)
Specialties & taxonomies
Emergency Medical Service Providers
Practice location
206 Depot St
Gardner, IL 60424-9441
Phone: (815) 557-0980
Approximate (ZIP-level) locationGet directions
Mailing address
684 Circle Dr
Coal City, IL 60416-4003
Registry dates
- Enumerated
- 2025-08-29
- Last updated
- 2025-08-29
- Certified
- 2025-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.