Provider Demographics
NPI:1700846433
Name:WOODS, TERRI JUNE (ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:JUNE
Last Name:WOODS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 LATHROP AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-2265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1402
Practice Address - Country:US
Practice Address - Phone:708-209-3120
Practice Address - Fax:708-488-4208
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096000034174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist