Individual
MS. MARISA J. FOSS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2211 N. OAK PARK AVENUE, CHICAGO, IL 60707-3392
(773) 385-5597
(773) 385-5488
Mailing address
PO BOX 209013, DALLAS, TX 75320-9013
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209006647
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006647
STATE LICENSE
IL
Enumeration date
08/19/2008
Last updated
03/25/2011
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