Carrie S Fortman in Elgin - Physician Assistant
Carrie S Fortman - NPI 1336211549
Carrie S Fortman is a Physician Assistant in Elgin, Illinois. Carrie S Fortman practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Carrie S Fortman is 1336211549. The last update date is 2020-03-11.
Carrie S Fortman's current location address is 1600 N Randall Rd, Elgin, Illinois. You can contact this provider via phone number 8472145100 and fax number 8472895579. The mailing address for Carrie S Fortman is 1600 N Randall Rd, Elgin, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carrie S Fortman |
|---|---|
| Address | 1600 N Randall Rd, Elgin, Illinois |
| Phone Number | 8472145100 |
| Fax Number | 8472895579 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1336211549 |
|---|---|
| Provider Enumeration Date | 2006-11-14 |
| Last Updated Date | 2020-03-11 |
Provider Mailing Address Detail
| Address | 1600 N Randall Rd |
|---|---|
| City | Elgin |
| State | Illinois (IL) |
| Post Code | 601237803 |
| Phone Number | 8472145100 |
| Fax Number | 8472895579 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 85001080 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 206147 | IL | MEDICARE GROUP PTAN | |
| F400138108 | IL | MEDICARE INDIVIDUAL PTAN |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Carrie S Fortman by the Centers for Medicare & Medicaid Services?
The Carrie S Fortman has been issued the NPI (National Provider Identifier) 1336211549, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Carrie S Fortman's physical address?
The Carrie S Fortman is physically located at 1600 N Randall Rd, in the city of Elgin, IL, with the postal code 601237803.
What is Carrie S Fortman's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Carrie S Fortman is Physician Assistant, and the taxonomy code that categorizes this field of expertise is 363A00000X.
When did the Carrie S Fortman receive its 1336211549?
The Carrie S Fortman was issued its 1336211549 on 2006-11-14, which is the date when the organization was assigned this unique identifier.
On what date did the Carrie S Fortman receive its 1336211549 assignment from the Centers for Medicare & Medicaid Services?
The Carrie S Fortman was assigned its 1336211549 by the Centers for Medicare & Medicaid Services on 2006-11-14.