Individual
EMILY FOSNAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2500 175TH ST, LANSING, IL 60438-1801
(708) 418-3612
(708) 418-3613
Mailing address
2500 175TH ST, LANSING, IL 60438-1801
(708) 418-3612
(708) 418-3613
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006435
IL
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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