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NPI Code Detail

MEDICARE: DR. KATIE FOREMAN O.D.

MEDICARE: DR. KATIE FOREMAN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046010429IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053521872
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE FOREMAN O.D.
Provider Business Mailing Address
First Line : 3241 S MICHIGAN AVE APT 4C
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4201
Country : US
Telephone Number : 312-949-7751
Fax Number :
Provider Business Practice Location Address
First Line : 3241 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4201
Country : US
Telephone Number : 312-949-7751
Fax Number : 312-949-7000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 03/17/2018

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Directions to “ DR. KATIE FOREMAN O.D.” Practice Location

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