Healthcare Provider Details

I. General information

NPI: 1225957467
Provider Name (Legal Business Name): TIANA RENEE FOY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22115 GOVERNORS HWY
RICHTON PARK IL
60471-1249
US

IV. Provider business mailing address

22115 GOVERNORS HWY
RICHTON PARK IL
60471-1249
US

V. Phone/Fax

Practice location:
  • Phone: 773-983-5252
  • Fax:
Mailing address:
  • Phone: 773-983-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberF00081683817
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: