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General NPI Number Information
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NPI Number | 1114120722
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Entity Type | Individual
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Provider Name | TERRI WASHINGTON M. D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2007
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 1835 BROADWAY ST SUITE 206
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City | MELROSE PARK
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State | IL
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Zip | 60160-2040
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Country | US
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Telephone | 708-345-2211
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Fax | 708-345-2224
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Provider Business Mailing Address
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Address Line | 1835 BROADWAY ST SUITE 206
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City | MELROSE PARK
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State | IL
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Zip | 60160-2040
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Country | US
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Telephone | 708-345-2211
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Fax | 708-345-2224
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036118965
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License Number State | IL
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