Organization Active NPI

Nona Fulk, M.D., S.C.

  • Obstetrics & Gynecology Physician
  • Normal, IL
National Provider Identifier
1063745883
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
36-096101 Issued in IL
Legal business name
NONA FULK, M.D., S.C.
Practice address
1300 Franklin Ave Ste 330
Normal, IL 61761-4204
Phone
(309) 808-0940
NPI assigned
Sep 11, 2009
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nona P Fulk, M.D.NPI 1619974227
Title
President
Phone
(309) 826-2966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 36-096101 IL Primary

Addresses

Primary practice location

1300 Franklin Ave Ste 330
Normal, IL 61761-4204

Mailing address

1300 Franklin Ave Ste 330
Normal, IL 61761-4204
Phone (309) 808-0940

National Provider Directory

National Provider Directory

Locations

1300 Franklin Ave
Ste 360
Normal, IL 61761
Phone (309) 268-6380

1300 Franklin Ave
Ste 36
Normal, IL 61761
Phone (309) 808-0940

1300 Franklin Ave
Ste 330
Normal, IL 61761
Phone (309) 454-7400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1063745883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE STE 330",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614204",
            "telephone_number": "309-808-0940",
            "fax_number": "309-808-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE STE 330",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614204",
            "telephone_number": "309-808-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NONA FULK, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "FULK",
        "authorized_official_first_name": "NONA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-826-2966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "36-096101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.