Individual
MR. DANIEL THOMAS FOUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
328 N NEIL ST STE C, CHAMPAIGN, IL 61820-3614
(217) 377-0299
(217) 492-8588
Mailing address
328 N NEIL ST STE C, CHAMPAIGN, IL 61820-3614
(217) 377-0299
(217) 492-8588
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209023867
IL
Other
Enumeration date
08/24/2021
Last updated
03/21/2025
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