Healthcare Provider Details

I. General information

NPI: 1326658931
Provider Name (Legal Business Name): DR. ANNA LEIGH TILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 E CHANDLER BLVD STE 100
PHOENIX AZ
85048-0432
US

IV. Provider business mailing address

206 W VAN WEISS BLVD
WEST BURLINGTON IA
52655-1532
US

V. Phone/Fax

Practice location:
  • Phone: 480-687-3790
  • Fax:
Mailing address:
  • Phone: 319-572-9361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number009517
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: