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NPI Code Detail

MEDICARE: MICHAEL FOGGS M.D.

MEDICARE: MICHAEL FOGGS M.D.
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
1207K00000XAllergy & Immunology Physician036-057389IL
2207R00000XInternal Medicine Physician036-057389IL

General Provider Information

NPI Number : 1669490330
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL FOGGS M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1225
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 9831 S WESTERN AVE
Second Line : SPECIALTY: 3RD FLOOR
City : CHICAGO
State : IL
Zip : 60643-1740
Country : US
Telephone Number : 773-445-3500
Fax Number : 773-445-0575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 03/15/2023

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