Provider Demographics
NPI:1346436516
Name:FOGEL, NAOMI R (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:R
Last Name:FOGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:BOX 54
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-6090
Mailing Address - Fax:312-227-9403
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:BOX 54
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6090
Practice Address - Fax:312-227-9403
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2014-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0361176952080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology