Healthcare Provider Details

I. General information

NPI: 1871810291
Provider Name (Legal Business Name): TIFFANI STROUP FRANADA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANI SUE STROUP D.O.

II. Dates (important events)

Enumeration Date: 04/25/2010
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 PARK AVE W STE 2850
HIGHLAND PARK IL
60035-2558
US

IV. Provider business mailing address

757 PARK AVE W STE 2850
HIGHLAND PARK IL
60035-2558
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2570
  • Fax:
Mailing address:
  • Phone: 847-570-2570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036133248
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: