MEDICARE: MS. DEBRA FRANCES FOX FNP

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
1	363LF0000X	Family Nurse Practitioner	209011390	IL

General Provider Information

NPI Number	:	1538316641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA FRANCES FOX FNP

Provider Business Mailing Address
First Line	:	213 N RACINE AVE
Second Line	:	SUITE 100
City	:	CHICAGO
State	:	IL
Zip	:	60607-1644
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	1541 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-1313
Country	:	US
Telephone Number	:	773-250-5222
Fax Number	:	773-866-8018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2008
Last Update Date	:	03/29/2017

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