DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MRS. TIFFANY KELLUM

MEDICARE: MRS. TIFFANY KELLUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental TherapistIL

General Provider Information

NPI Number : 1710780226
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY KELLUM
Provider Business Mailing Address
First Line : 281 W CASTINE WAY
Second Line :
City : BEECHER
State : IL
Zip : 60401-3109
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LIBERTY BLVD APT 1
Second Line :
City : WESTMONT
State : IL
Zip : 60559-1348
Country : US
Telephone Number : 630-426-9386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 03/31/2025

Similar Medicare Providers

1962365585 — MS. TIARA BROWN
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 630-426-9386
Practice Fax:
1770446080 — MISS MALENA LIVERA CARRANZA
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 630-426-9386
Practice Fax:
1083425722 — JENNA KAREN PRYOR M.S., CF-SLP
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 938-663-0426
Practice Fax:
1265229405 — ASYA A HAYES DT
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 630-426-9386
Practice Fax:
1780472928 — MOCHINIQUE JAMASON
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 630-426-9386
Practice Fax:
1023801602 — MADELINE KOWALSKI
Practice Location Address:
4101 LIBERTY BLVD APT 1
WESTMONT, IL
60559-1348
Practice Phone: 630-426-9386
Practice Fax:

Directions to “ MRS. TIFFANY KELLUM ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.