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NPI Code Detail

MEDICARE: FOSTER HEALTH PLLC

MEDICARE: FOSTER HEALTH PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center
2261QP2300XPrimary Care Clinic/Center
3208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1770463713
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOSTER HEALTH PLLC
Provider Business Mailing Address
First Line : PO BOX 552
Second Line :
City : LISLE
State : IL
Zip : 60532-0552
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 980 PLAINFIELD RD
Second Line :
City : WILLOWBROOK
State : IL
Zip : 60527-1705
Country : US
Telephone Number : 630-541-6679
Fax Number : 630-812-1051
Authorized Official
Title or Position : OWNER
Name : SAMUEL ELBERTS
Credential :
Telephone Number : 331-251-4805
Provider Enumeration Date : 09/02/2025
Last Update Date : 03/05/2026

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Directions to “FOSTER HEALTH PLLC ” Practice Location

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