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1477555308
BRENT T. FONNER
AURORA, IL
NPI
1477555308
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: IL 036088383)
Enumeration Date
2005-08-11
Last Update Date
2008-05-13
Business Address
-- BRENT T. FONNER M.D.
PROVENA MERCY MEDICAL CENTER / PATHOLOGY DEPARTMENT 1325 NORTH HIGHLAND AVENUE
AURORA, IL 60506
Phone number: 630-859-2222
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Mailing Address
-- BRENT T. FONNER M.D.
520 E 22ND ST
LOMBARD, IL 60148-6110
Phone number: 630-874-2542
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