Provider Demographics
NPI:1063690469
Name:FENOGLIO, JAMES STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEVEN
Last Name:FENOGLIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3319 N ELSTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5811
Mailing Address - Country:US
Mailing Address - Phone:773-751-7200
Mailing Address - Fax:773-583-4295
Practice Address - Street 1:3319 N ELSTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5811
Practice Address - Country:US
Practice Address - Phone:773-751-7200
Practice Address - Fax:773-583-4295
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2013-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01028954207QA0505X
IL036103995207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine