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General NPI Number Information
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NPI Number | 1477144137
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Entity Type | Individual
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Provider Name | TANYA L MYLES
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 9030 KENNEDY DR
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City | DES PLAINES
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State | IL
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Zip | 60016-4918
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Country | US
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Telephone | 847-250-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 9114 WAUKEGAN RD PO BOX 916
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City | MORTON GROVE
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State | IL
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Zip | 60053
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Country | US
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Telephone | 847-250-7344
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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