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Carolyn Elaine Fitzpatrick

Family Medicine

Allopathic & Osteopathic Physicians

1 Erie Ct, Suite 6160, Oak Park, IL 60302-2566

PECOS Enrollment

This provider is enrolled in PECOS as CAROLYN FITZPATRICK.

Based on the most recent information from CMS, provider Carolyn Elaine Fitzpatrick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1205872462
Provider Type
Individual
Full Name
Fitzpatrick, Carolyn Elaine
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
6/22/2006
Last Updated
7/29/2013

Contact Information

Practice Location

1 Erie Ct, Suite 6160, Oak Park, IL 60302-2566

(708) 763-1490

(708) 763-7232

Mailing Location

1 Erie Ct, Suite 6160, Oak Park, IL 60302-2566

(708) 763-1490

(708) 763-7232

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 036-113113 Illinois

Carolyn Elaine Fitzpatrick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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