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Individual

JAMES LEWIS FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
4309 W MEDICAL CENTER DR STE B100, MCHENRY, IL 60050
(815) 344-8585
(815) 344-8610
Mailing address
4309 W MEDICAL CENTER DR STE B100, MCHENRY, IL 60050-8438
(815) 344-8585
(815) 344-8610

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209011623
IL
363LF0000X
Family Nurse Practitioner
Primary
209011623
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209011623
STATE LICENSE
IL
Enumeration date
05/27/2014
Last updated
06/27/2018
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