Provider Demographics
NPI:1255492930
Name:FUHRMAN, TERESA SURIANO (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:SURIANO
Last Name:FUHRMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E OGDEN
Mailing Address - Street 2:SUITE 220 HERITAGE PROFESSIONAL ASSOCIATES
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60558-3546
Mailing Address - Country:US
Mailing Address - Phone:630-325-5300
Mailing Address - Fax:630-325-5309
Practice Address - Street 1:120 E OGDEN
Practice Address - Street 2:SUITE 220 HERITAGE PROFESSIONAL ASSOCIATES
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60558-3546
Practice Address - Country:US
Practice Address - Phone:630-325-5300
Practice Address - Fax:630-325-5309
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02215636OtherBCBS