BEVERLY FOWLER (NPI# 1255853172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255853172 |
| Entity Type | Individual |
| Full Name | BEVERLY FOWLER |
| Practice Address |
11624 S. May Street Chicago IL 60643 |
| Mailing Address |
11624 S May St Chicago IL 60643-5133 |
| Practice Telephone | 7732910674 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
46007490684F | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 46007490684F | IL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798552 | Beverly Fowler | Nurse Practitioner | 440 Us Highway 84 E, Cairo, GA 39828-1647 | 2020-10-23 |
| 1063061380 | Beverly Lynn Fowler | Counselor | 1020 Main Street, Lewiston, ID 83501-1842 | 2019-09-09 |
| Street Address |
11624 S. MAY STREET |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1275146599 | Ryan Mather | Student in an Organized Health Care Education/Training Program | 155 N Michigan Ave Ste 566, Chicago, IL 60601-7799 | 2020-08-26 |
| 1831701010 | Alexandra Klonis | Student in an Organized Health Care Education/Training Program | 676 N Saint Clair St Ste 6-108, Chicago, IL 60611-2927 | 2020-08-19 |
| 1851903389 | Brittney Christine Evans | Student in an Organized Health Care Education/Training Program | 1901 N Clybourn Ave Ste 302&304, Chicago, IL 60614-5090 | 2020-08-17 |
| 1205446358 | Kai Lai Chu | Student in an Organized Health Care Education/Training Program | 600 N Fairbanks Ct Unit 3505, Chicago, IL 60611-5869 | 2020-08-04 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1407474463 | Madison Nicole Schulenberg | Student in an Organized Health Care Education/Training Program | 1111 W 14th Pl Unit 119, Chicago, IL 60608-2796 | 2020-07-07 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.