Healthcare Provider Details

I. General information

NPI: 1528740958
Provider Name (Legal Business Name): MARIA HELENA FOX MCLEOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA HELENA FOX

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 W FULLERTON AVE
CHICAGO IL
60647-2319
US

IV. Provider business mailing address

3600 W FULLERTON AVE
CHICAGO IL
60647-2319
US

V. Phone/Fax

Practice location:
  • Phone: 773-782-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209028092
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041453344
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: