Individual
MR. JERRY L FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-3303
(217) 383-3265
Mailing address
611 W PARK STREET, BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041-213052
IL
367500000X
Certified Registered Nurse Anesthetist
28132521A
IN
Other
Enumeration date
12/25/2006
Last updated
07/06/2016
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