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NPI Code Detail

MEDICARE: COLLEEN ANN FOLEY CNP

MEDICARE:   COLLEEN ANN FOLEY  CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209015072IL

General Provider Information

NPI Number : 1790237147
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN ANN FOLEY CNP
Provider Business Mailing Address
First Line : 4800 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-3226
Country : US
Telephone Number : 773-331-1051
Fax Number :
Provider Business Practice Location Address
First Line : 4800 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-3226
Country : US
Telephone Number : 773-331-1051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2016
Last Update Date : 11/02/2016

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