Individual provider Active NPI

Lori Renee' Foster, D.C.

  • Chiropractor
  • Bourbonnais, IL
National Provider Identifier
1992883839
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
588 William R Latham Sr Dr
Suit 5
Bourbonnais, IL 60914-2326
Phone
(815) 932-7800
Fax
(815) 932-7806
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

588 William R Latham Sr Dr
Suit 5
Bourbonnais, IL 60914-2326

Mailing address

588 William R Latham Sr Dr
Suit 5
Bourbonnais, IL 60914-2326
Phone (815) 932-7800

Other identifiers 1

IdentifierTypeStateIssuer
04632068OtherILBC/BC OF ILLINOIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060503000271 IL Practitioner - Chiropractic 2961412101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

215 E N St
Bradley, IL 60915-1269
Phone (815) 932-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007512ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Foster Chiropractic S.C Chiropractor CurrentSince Oct 1, 2005 Accepting new patients

Locations

588 Wm Latham Dr
Ste 5
Bourbonnais, IL 60914
Phone (815) 932-7800

215 E North St
Bradley, IL 60915
Phone (815) 932-7800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1992883839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R LATHAM SR DR",
            "address_2": "SUIT 5",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142326",
            "telephone_number": "815-932-7800",
            "fax_number": "815-932-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 WILLIAM R LATHAM SR DR",
            "address_2": "SUIT 5",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142326",
            "telephone_number": "815-932-7800",
            "fax_number": "815-932-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "LORI",
        "middle_name": "RENEE'",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BC OF ILLINOIS",
            "identifier": "04632068",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.