DR. JOHN M FULTZ M.D. NPI 1679664163

NPI Information

  • NPI: 1679664163
  • Provider Name: DR. JOHN M FULTZ, M.D.
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1314 CHURCH ST
    EVANSTON, IL
    ZIP 60201
  • Phone: (773) 275-6349

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NPI Details

DR. John M Fultz, M.D. is an internal medicine in Evanston, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. DR. John M Fultz, M.D. NPI is 1679664163. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1314 CHURCH ST
EVANSTON, IL
ZIP 60201-508
Phone: (773) 275-6349
Fax: (773) 275-6385

The NPI 1679664163 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 1/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine036042979ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036042979MEDICAIDILLINOIS
2613910MEDICARE PINILLINOIS
3D13905MEDICARE UPINILLINOIS
414D0876728OTHERILLINOISCLIA ID MEDICARE
5792111199OTHERILLINOISRAILROAD MEDICARE ID
621608069OTHERILLINOISBCBS INS ID
7363179161OTHERILLINOISTAX ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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