Healthcare Provider Details

I. General information

NPI: 1922915941
Provider Name (Legal Business Name): TIFFANY DEMBEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFANI DEMBEK

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 GRANDSTAND PL
ELGIN IL
60123-6603
US

IV. Provider business mailing address

837 SYMPHONY DR
AURORA IL
60504-5554
US

V. Phone/Fax

Practice location:
  • Phone: 630-632-0068
  • Fax:
Mailing address:
  • Phone: 630-632-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: