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NPI Code Detail

MEDICARE: MARY KAY FOLEY CPNP

MEDICARE: MARY KAY FOLEY CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner209002010IL

General Provider Information

NPI Number : 1235148032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KAY FOLEY CPNP
Provider Business Mailing Address
First Line : 2418 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-2940
Country : US
Telephone Number : 312-666-3494
Fax Number :
Provider Business Practice Location Address
First Line : 2418 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-2940
Country : US
Telephone Number : 312-666-3494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 08/11/2021

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