Healthcare Provider Details

I. General information

NPI: 1245805456
Provider Name (Legal Business Name): TAMMY RINGLE DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SELECT REHAB 2600 COMPASS RD.
GLENVIEW IL
60026
US

IV. Provider business mailing address

738 BROOKWOOD DR
FRANKLIN NC
28734-1977
US

V. Phone/Fax

Practice location:
  • Phone: 877-787-3422
  • Fax: 847-441-4130
Mailing address:
  • Phone: 828-342-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA2957
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: