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NPI Code Detail

MEDICARE: LEA FOY OS CAPILI

MEDICARE: LEA FOY OS CAPILI
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 Practitioner209.026636IL

General Provider Information

NPI Number : 1841984176
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEA FOY OS CAPILI
Provider Business Mailing Address
First Line : 5252 N GLENWOOD AVE APT H2
Second Line :
City : CHICAGO
State : IL
Zip : 60640-2236
Country : US
Telephone Number : 210-929-0147
Fax Number :
Provider Business Practice Location Address
First Line : 3943 W 31ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4936
Country : US
Telephone Number : 773-523-8773
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2023
Last Update Date : 06/08/2023

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Directions to “ LEA FOY OS CAPILI ” Practice Location

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