Fugazy, Lenni
Fugazy, Lenni is an individual health care provider with primary practice located at 1611 W Harrison St # 400 , Chicago IL 60612-4861. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Fugazy, Lenni can be contacted via phone (312) 243-4244.Contact Information
Primary practice address
1611 W Harrison St # 400
Chicago IL 60612-4861
Phone: (312) 243-4244
Fax: (312) 942-1517
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9104242 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 085002149 | Illinois |
Profile Details
NPI number | 1619922481 |
---|---|
LBN Legal business name | Fugazy, Lenni |
Credentials | Physician Assistant (PA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 23rd, 2006 |
Last updated | Jan 12th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619922481 | NPPES |
Illinois | Other | 1633878 | BCBS PPO |
Illinois | Other | P00990032 | BCBS PPO |
Illinois | MEDICAID | 292866300 | BCBS PPO |
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