Individual
JILLIAN E FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
34TH STREET AND CIVIC CENTER BOULEVARD, PHILADELPHIA, PA 19104
(215) 590-1000
Mailing address
34TH STREET AND CIVIC CENTER BOULEVARD, PHILADELPHIA, PA 19104
(215) 590-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057539
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570413003
BCBS OF WNY
NY
01
—
11563506
CAQH
NY
01
—
177880BF
PREFERRED CARE
NY
01
—
9511753
IHA
NY
01
—
P00236020
MEDICARE RAILROAD
NY
Enumeration date
04/28/2006
Last updated
05/24/2021
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