Provider Demographics
NPI:1396945184
Name:TERPSTRA, BARBARA S (MD)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:S
Last Name:TERPSTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:S
Other - Last Name:ZUNIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4545 DEPARTMENT
Mailing Address - Street 2:SW SUBURBAN MIDWEST VASCULAR CENTER
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-4545
Mailing Address - Country:US
Mailing Address - Phone:630-322-9126
Mailing Address - Fax:630-322-9128
Practice Address - Street 1:10755-59 WEST 143RD STREET
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5701
Practice Address - Country:US
Practice Address - Phone:708-590-7150
Practice Address - Fax:708-590-7151
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-095576174400000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215973Medicare PIN