Individual
MICHAEL ROBERT FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153
(406) 350-2539
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(406) 350-2539
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036151582
IL
207L00000X
Anesthesiology Physician
125071644
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2017
Last updated
05/19/2022
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