| Doctor Name: | TERESA LYNN BURKS |
| NPI Number: | 1235120486 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP, APN |
| License Number: | 209006576 |
| Business Practice Address: | 105 S Locust Tremont, IL - 615680187 |
| Business Phone Number: | 3099252961 |
| Business Fax Number: | 3099254221 |
| Mailing Address: | 105 S Locust, Po Box 187 TREMONT |
| State: | IL |
| Postal Code: | 615680187 |
| Phone Number: | 3099252961 |
| Fax Number: | 3099254221 |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 08/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209006576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |