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General NPI Number Information
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NPI Number | 1063806990
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Entity Type | Individual
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Provider Name | COREY CHRISTIAN FOSTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2015
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE M/C 9006
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone | 570-573-2793
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Fax |
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Provider Business Mailing Address
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Address Line | 719 THOMPSON LN
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City | NASHVILLE
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State | TN
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Zip | 37204-3609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 125067927
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License Number State | IL
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