| Doctor Name: | HEATHER LYNN FORYS |
| NPI Number: | 1902218308 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209011417 |
| Business Practice Address: | 8 N 3rd St Altamont, IL - 624111408 |
| Business Phone Number: | 6184836151 |
| Business Fax Number: | 6184836153 |
| Mailing Address: | 1207 Network Centre Dr Ste 3, EFFINGHAM |
| State: | IL |
| Postal Code: | 624014632 |
| Phone Number: | 2173472707 |
| Fax Number: | 2173472827 |
| NPI Enumeration Date: | 05/20/2014 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209011417 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |