Organization
FENIX FAMILY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUISE BERNER-HOLMBERG MD (DIRECTOR)
(847) 909-2004
Entity
Organization
Contact information
Practice address
130 WASHINGTON AVE, HIGHWOOD, IL 60040-1122
(847) 909-2004
(847) 266-0961
Mailing address
130 WASHINGTON AVE, HIGHWOOD, IL 60040-1122
(847) 909-2004
(847) 266-0961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
336-044483
—
261QP2300X
Primary Care Clinic/Center
036082171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679788772
NPI
IL
Enumeration date
11/24/2009
Last updated
04/05/2011
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