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General NPI Number Information
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NPI Number | 1427421916
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Entity Type | Individual
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Provider Name | CHRIS TANZER LMT
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Gender | Male
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 710 E OGDEN AVE SUITE 640
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City | NAPERVILLE
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State | IL
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Zip | 60563-8602
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Country | US
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Telephone | 630-492-1213
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Fax |
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Provider Business Mailing Address
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Address Line | 2476 ONEIDA LN
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City | NAPERVILLE
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State | IL
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Zip | 60563-4097
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Country | US
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Telephone | 630-492-1213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227016648
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License Number State | IL
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