Healthcare Provider Details

I. General information

NPI: 1598987570
Provider Name (Legal Business Name): TESSA HERMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 W ARMITAGE AVE STE B
CHICAGO IL
60614-4102
US

IV. Provider business mailing address

1151 W WASHINGTON BLVD UNIT 103
CHICAGO IL
60607-2002
US

V. Phone/Fax

Practice location:
  • Phone: 312-414-0058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001607
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4481-026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: