Provider Demographics
NPI:1538881420
Name:FOYTIK, TAYLOR (RN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:FOYTIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 O CONNELL ST
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2934
Mailing Address - Country:US
Mailing Address - Phone:170-890-3026
Mailing Address - Fax:
Practice Address - Street 1:719 OCONNELL STREET
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-6045
Practice Address - Country:US
Practice Address - Phone:708-903-0266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.498736163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty