Individual
CHRISTIE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1104 S 42ND ST, MOUNT VERNON, IL 62864-6216
(618) 315-6360
(618) 315-6356
Mailing address
1104 S 42ND ST, MOUNT VERNON, IL 62864-6216
(618) 315-6360
(618) 315-6356
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036112920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361129202
—
IL
01
—
DU1659
RR MEDICARE PTAN
IL
01
—
IL8716001
MEDICARE PTAN
IL
Enumeration date
06/15/2006
Last updated
02/21/2014
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