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AMANDA M FAGAN
NPI 1790664142
Emergency Medical Technician, Paramedic in Gardner, IL

Active since August 29, 2025
206 DEPOT ST, GARDNER, IL 60424(815) 557-0980 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Amanda M Fagan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA M FAGAN (NPI 1790664142) is an individual emergency medical technician, paramedic in Gardner, Illinois, licensed in Illinois (000828467) and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1790664142
Entity TypeIndividualFemale
Primary Taxonomy146L00000X
Provider Legal NameAMANDA M FAGAN
Location Address206 DEPOT STGardner, IL 60424-9441
Mailing Address684 Circle DrCoal City, IL 60416-4003
Phone(815) 557-0980
Sole ProprietorNo
Enumeration DateAugust 29, 2025
NPPES CertifiedAugust 29, 2025
✔ NPI 1790664142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medical Technician, ParamedicEmergency Medical Service Providers
Taxonomy Code146L00000X
License✔ Licensed in IL · 000828467
Definition
An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards.
206 DEPOT ST, Gardner, IL 60424
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARDNER FIRE PROTECTION DISTRICT
Ambulance (Land Transport)
206 DEPOT ST
GARDNER, IL 60424
Grundy County (815) 237-8806

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Fagan's NPI number?

The NPI number for Amanda Fagan is 1790664142. It was assigned to this individual provider in the NPPES registry on August 29, 2025.

Where is Amanda Fagan located?

Amanda Fagan practices at 206 Depot St, Gardner, IL 60424. The listed phone number is (815) 557-0980.

What is Amanda Fagan's specialty?

The primary specialty registered for this NPI is Emergency Medical Technician, Paramedic with taxonomy code 146L00000X.

When was this NPI record last updated?

The NPPES record for Amanda Fagan was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.