Individual
AUDREY FENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
259 E ERIE ST STE 2450, CHICAGO, IL 60611
(312) 694-9676
Mailing address
2020 N LINCOLN PARK W APT 10L, CHICAGO, IL 60614-4481
(502) 295-4508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006630
IL
Other
Enumeration date
07/20/2018
Last updated
07/31/2018
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