Beverly Fowler

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

46007490684F Issued in IL

Practice address

11624 S. May Street
Chicago, IL 60643

Phone

(773) 291-0674

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1255853172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11624 S MAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606435133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11624 S. MAY STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60643",
            "telephone_number": "773-291-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "BEVERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "46007490684F",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "46007490684F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Harry Fournier, MD
• Fourrivers
• Christine Therese Foushee
• Blair R Foushi
• Matthew Charles Fouts, M.D.
• Brenda Fowler, CNM
• Bridget Fowler, PT, DPT
• Edwaed Weldon Fowler, PAC
• Jasmine Ashley Fowler, APRN
• Kandi M Fowler, CADC,MISA1,CAMS11

• Student in an Organized Health Care Education/Training Program in Chicago, IL
• Providers in Chicago, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.