National Provider Identifier Database

LENNI FUGAZY, PA – NPI #1619922481
Surgical


Contact Information

LENNI FUGAZY, PA
1611 W HARRISON ST # 400
CHICAGO, IL60612-4861
Phone: 312-243-4244
Fax: 312-942-1517
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for LENNI FUGAZY

NPI Number 1619922481
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/23/2006
Last updated 01/12/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • FL License #: PA9104242
  • IL License #: 085002149
  • FL Medicaid: 292866300
  • IL Other: 1633878 BCBS PPO
  • IL Other: P00990032 RR MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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