Individual
TAMARA DEE FOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1250 W WHITTAKER ST, SALEM, IL 62881-1917
(618) 548-3740
(618) 548-3705
Mailing address
1250 W WHITTAKER ST, SALEM, IL 62881-1917
(618) 548-3740
(618) 548-3705
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209003173
IL
363LF0000X
Family Nurse Practitioner
209003173
IL
363LF0000X
Family Nurse Practitioner
907799
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207988
MEDICARE GROUP NUMBER
IL
01
—
500027819
RAILROAD MEDICARE NUMBER
IL
01
—
CJ2166
GROUP RR MEDICARE NUMBER
IL
Enumeration date
04/07/2006
Last updated
09/25/2025
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