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General NPI Number Information
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NPI Number | 1922305242
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Entity Type | Organization
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Legal Business Name | FIDELIS HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 17625 EL CAMINO REAL SUITE 210
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City | HOUSTON
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State | TX
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Zip | 77058-3052
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Country | US
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Telephone | 281-954-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 20 N MARTINGALE RD SUITE 180
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City | SCHAUMBURG
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State | IL
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Zip | 60173-2412
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Country | US
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Telephone | 847-605-0501
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Fax | 847-517-1085
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. DAWN GILBERT
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Credential |
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Telephone | 847-605-0501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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