Healthcare Provider Details

I. General information

NPI: 1215936984
Provider Name (Legal Business Name): REGINA FOSTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 CENTER ST
ELGIN IL
60120-2125
US

IV. Provider business mailing address

150 QUAIL RIDGE DR
WESTMONT IL
60599
US

V. Phone/Fax

Practice location:
  • Phone: 847-429-8750
  • Fax: 847-429-8978
Mailing address:
  • Phone: 630-321-8300
  • Fax: 630-321-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209002123
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: