Individual
DR. TERAH HENNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 W HARRISON ST STE 400, CHICAGO, IL 60612-4861
(877) 632-6637
(708) 409-5179
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(877) 632-6637
(708) 409-5179
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01096312A
IN
207X00000X
Orthopaedic Surgery Physician
036174905
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
01096312A
IN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
036174905
IL
Other
Enumeration date
04/03/2020
Last updated
07/09/2025
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