Individual
KWAME G. FOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
559 STATE ST, HAMMOND, IN 46320-1533
(219) 937-3300
(219) 803-7252
Mailing address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-3878
(312) 949-7770
(312) 949-7742
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01076051A
IN
207Q00000X
Family Medicine Physician
036-114411
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114411
—
IL
Enumeration date
12/11/2006
Last updated
12/23/2015
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