Organization Name: | TERRI L FOSTER |
NPI Number: | 1366479701 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERRI L FOSTER (PRESIDENT) |
Mailing Address: | 4440 Lincoln Hwy Suite 102 Matteson |
State: | IL US |
Postal Code: | 604432349 |
Phone Number: | 7084813338 |
Fax Number: | 7084818643 |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 03/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |