Individual
DOUGLAS FOULKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6121 N HERMITAGE AVE, CHICAGO, IL 60660-2305
(773) 973-3005
(773) 973-3006
Mailing address
6121 N HERMITAGE AVE, CHICAGO, IL 60660-2305
(773) 973-3005
(773) 973-3006
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01051286
IN
207P00000X
Emergency Medicine Physician
Primary
036-059577
IL
207P00000X
Emergency Medicine Physician
35104
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059577
—
IL
Enumeration date
07/13/2006
Last updated
12/23/2009
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