| Doctor Name: | JEFFREY F FULLENKAMP |
| NPI Number: | 1225017965 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | |
| Business Practice Address: | 2701 17th St Rock Island, IL - 612015351 |
| Business Phone Number: | 3097795000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 689, LAKE FOREST |
| State: | IL |
| Postal Code: | 600450689 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 10/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207LP2900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Anesthesiology |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |