MEDICARE: DR. STEVEN CRAIG FOX D.O.

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	208D00000X	General Practice Physician	036.064714	IL

General Provider Information

NPI Number	:	1649612961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN CRAIG FOX D.O.

Provider Business Mailing Address
First Line	:	125 NORTH HALSTED STREET
Second Line	:	SUITE 303
City	:	CHICAGO
State	:	IL
Zip	:	60661-2156
Country	:	US
Telephone Number	:	312-258-0575
Fax Number	:	312-648-1569

Provider Business Practice Location Address
First Line	:	125 NORTH HALSTED STREET
Second Line	:	SUITE 303
City	:	CHICAGO
State	:	IL
Zip	:	60661-2156
Country	:	US
Telephone Number	:	312-258-0575
Fax Number	:	312-648-1569

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

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	07/29/2013

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