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NPI Code Detail

MEDICARE: STEPHANIE FUMO RN

MEDICARE:   STEPHANIE  FUMO  RN
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
1163W00000XRegistered Nurse041498754IL

General Provider Information

NPI Number : 1568241099
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE FUMO RN
Provider Business Mailing Address
First Line : 30 N MICHIGAN AVE STE 424
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3844
Country : US
Telephone Number : 312-279-9981
Fax Number :
Provider Business Practice Location Address
First Line : 3209 N LAKEWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3215
Country : US
Telephone Number : 312-279-9981
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 09/25/2023

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