Individual
PHOEBE A. FOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(773) 843-3601
(773) 843-2704
Mailing address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(773) 843-3601
(773) 843-2704
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085000856
STATE LICENSE
IL
01
—
1032682
SPECIALTY BOARDS
IL
01
—
385000551
CS LICENSE
IL
Enumeration date
06/30/2006
Last updated
03/07/2023
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