Provider Demographics
NPI:1487207007
Name:HARVEY, FELICIA
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60204-3216
Mailing Address - Country:US
Mailing Address - Phone:847-401-0519
Mailing Address - Fax:312-715-7023
Practice Address - Street 1:701 MAIN ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60204-3216
Practice Address - Country:US
Practice Address - Phone:847-401-0519
Practice Address - Fax:312-715-7023
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker