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General NPI Number Information
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NPI Number | 1144473745
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Entity Type | Organization
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Legal Business Name | ADRIENNE M BURFORD-FOGGS MD SC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 233 E ERIE ST STE 701
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City | CHICAGO
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State | IL
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Zip | 60611-5933
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Country | US
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Telephone | 312-664-4000
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Fax | 312-664-4006
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Provider Business Mailing Address
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Address Line | 233 E ERIE ST STE 701
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City | CHICAGO
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State | IL
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Zip | 60611-5933
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Country | US
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Telephone | 312-664-4000
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Fax | 312-664-4006
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ADRIENNE M BURFORD-FOGGS MD SC
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Credential | M.D.
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Telephone | 312-926-0551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036072741
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License Number State | IL
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