Healthcare Provider Details

I. General information

NPI: 1184548950
Provider Name (Legal Business Name): TIANA ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 LAKE COOK RD STE 312
DEERFIELD IL
60015-4933
US

IV. Provider business mailing address

2734 SALLMON AVE
WAUKEGAN IL
60087-3513
US

V. Phone/Fax

Practice location:
  • Phone: 877-486-4140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-285396
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: