Individual
MR. TERRY J SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
355 W CARPENTER STREET, SUITE B, SPRINGFIELD, IL 62702-4945
(217) 789-1450
(217) 789-1454
Mailing address
355 W CARPENTER STREET, SUITE B, SPRINGFIELD, IL 62702-4945
(217) 789-1450
(217) 789-1454
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
IL
224P00000X
Prosthetist
—
IL
Other
Enumeration date
07/19/2006
Last updated
09/11/2025
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