Individual
MICHAEL T FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 W HIGHWAY 22, BARRINGTON, IL 60010-7509
(847) 381-9600
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-7076
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036087540
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635726
BLUE SHIELD OF ILLINOIS
IL
05
—
036087540
—
IL
Enumeration date
07/14/2005
Last updated
12/21/2021
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