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General NPI Number Information
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NPI Number | 1033433453
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Entity Type | Organization
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Legal Business Name | WARREN FUREY MD LLC
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 201 E HURON ST STE 11-230
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City | CHICAGO
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State | IL
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Zip | 60611-2894
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Country | US
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Telephone | 312-642-6868
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Fax | 312-642-2902
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Provider Business Mailing Address
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Address Line | 201 E HURON ST STE 11-230
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City | CHICAGO
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State | IL
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Zip | 60611-2894
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Country | US
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Telephone | 312-642-6868
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Fax | 312-642-2902
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MRS. JODI RAE SEVERSON
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Credential |
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Telephone | 815-941-1317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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