Provider Demographics
NPI:1649612961
Name:FOX, STEVEN CRAIG (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CRAIG
Last Name:FOX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:125 NORTH HALSTED STREET
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2156
Mailing Address - Country:US
Mailing Address - Phone:312-258-0575
Mailing Address - Fax:312-648-1569
Practice Address - Street 1:125 NORTH HALSTED STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2156
Practice Address - Country:US
Practice Address - Phone:312-258-0575
Practice Address - Fax:312-648-1569
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.064714208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice