Healthcare Provider Details

I. General information

NPI: 1396945184
Provider Name (Legal Business Name): BARBARA S TERPSTRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA S ZUNIGA MD

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10755-59 WEST 143RD STREET
ORLAND PARK IL
60462-5701
US

IV. Provider business mailing address

4545 DEPARTMENT SW SUBURBAN MIDWEST VASCULAR CENTER
CAROL STREAM IL
60122-4545
US

V. Phone/Fax

Practice location:
  • Phone: 708-590-7150
  • Fax: 708-590-7151
Mailing address:
  • Phone: 630-322-9126
  • Fax: 630-322-9128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036-095576
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number036-095576
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: