Most Relevant Information
Provider Data
| NPI Number: | 1003471194 |
| Provider Name: | AMANDA NICHOLE FENTON |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | F535-0149-7743-00 |
Most Important Dates
| Enumeration Date: | 05/05/2019 |
| Last Updated: | 05/05/2019 |
Provider Practice Location
2420 HIGH MEADOW RD
NAPERVILLE
IL
605645375
Practice Location Phone/Fax
| Phone: | 6306993341 |
| Fax: |
Provider Mailing Location
2420 HIGH MEADOW RD
NAPERVILLE
IL
605645375
Provider Mailing Phone/Fax
| Phone: | 6306993341 |
| Fax: |