Individual
DR. TERESE J LAUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1515 W WALNUT ST, SUITE 12, JACKSONVILLE, IL 62650-1150
(217) 243-1101
(217) 243-5003
Mailing address
1515 W WALNUT ST, SUITE 12, JACKSONVILLE, IL 62650-1150
(217) 243-1101
(217) 243-5003
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004832
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004832
—
IL
01
—
016004832/4974780001
MEDICARE DMERC
IL
01
—
034378
HEALTH ALLIANCE
IL
01
—
06932011
BCBS OF ILLINOIS
IL
01
—
330738/270056166
HEALTHLINK PPO
IL
01
—
P00027606/DA1788
RAILROAD MEDICARE
IL
Enumeration date
06/12/2006
Last updated
10/01/2014
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