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NPI Code Detail

MEDICARE: MICHELLE FOUCHE PA-C

MEDICARE: MICHELLE FOUCHE PA-C
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
1363A00000XPhysician Assistant085002836IL

General Provider Information

NPI Number : 1881970036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE FOUCHE PA-C
Provider Business Mailing Address
First Line : 300 N OTTAWA ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-4009
Country : US
Telephone Number : 815-726-0311
Fax Number :
Provider Business Practice Location Address
First Line : 300 N OTTAWA ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-4009
Country : US
Telephone Number : 815-726-0311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2011
Last Update Date : 05/06/2020

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Directions to “ MICHELLE FOUCHE PA-C” Practice Location

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