Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOHN D FULK, P.A.
ActiveJOHN D FULK, P.A. is a Physician Assistant healthcare provider located in NORMAL, Illinois. NPI 1063419679 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · NORMAL, IL
Registration Details
- NPI Number
- 1063419679
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 29, 2005 (21.158785661915 yrs)
- Last Updated
- Apr 4, 2019
- License
-
085001126 (IL)
Practice Information
- Address
-
1302 FRANKLIN AVESUITE 4800NORMAL, IL, 617613551Browse IL providers · Browse ZIP 61761
- Phone
- 3094545900
- Fax
- 3094542820
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in NORMAL, IL
| Name | Credential | NPI |
|---|---|---|
| DANA DALBAK | PA-C | 1790721298 |
| JOHANNAH ISAIA | — | 1922199587 |
| MS. KAREN JANE BANDUSCH HARRIS | PA-C | 1003994104 |
| MR. JOSEPH V PILLER | P.A. | 1710024674 |
| MS. JENNIFER VICTORIA MENENDEZ | PA | 1497206551 |
| NICHOLAS GURGANIOUS | PA-C | 1801358627 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.