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General NPI Number Information
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NPI Number | 1033043757
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Entity Type | Organization
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Legal Business Name | FOG & FERN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 1707 E MAIN ST STE 8
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City | OLNEY
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State | IL
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Zip | 62450-3156
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Country | US
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Telephone | 618-879-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 7443 E DUNDAS LN
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City | CLAREMONT
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State | IL
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Zip | 62421-2110
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | KRYSTAL VOLK
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Credential | APRN
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Telephone | 618-879-2150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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