Provider Demographics
NPI:1366465098
Name:FOSTER, ILA L (DC)
Entity Type:Individual
Prefix:DR
First Name:ILA
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 EDMONDSON PIKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211
Mailing Address - Country:US
Mailing Address - Phone:615-834-2600
Mailing Address - Fax:615-834-2662
Practice Address - Street 1:5511 EDMONDSON PIKE
Practice Address - Street 2:SUITE 205
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5870
Practice Address - Country:US
Practice Address - Phone:615-834-2600
Practice Address - Fax:615-834-2662
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4116809OtherBCBS OF TN
TNV08733Medicare UPIN
TN3973833Medicare ID - Type Unspecified