Provider Demographics
NPI:1871890863
Name:FIDELIS HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:FIDELIS HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-605-0501
Mailing Address - Street 1:20 N MARTINGALE RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-2412
Mailing Address - Country:US
Mailing Address - Phone:847-605-0501
Mailing Address - Fax:847-517-1085
Practice Address - Street 1:9300 HARRIS CORNERS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-3790
Practice Address - Country:US
Practice Address - Phone:704-307-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty