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General NPI Number Information
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NPI Number | 1518186998
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Entity Type | Individual
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Provider Name | TANISHA CHAMBERS P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5211 OLD ORCHARD RD
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City | SKOKIE
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State | IL
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Zip | 60077-1021
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Country | US
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Telephone | 248-302-8245
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Fax |
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Provider Business Mailing Address
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Address Line | 11419 WEATHERING OAKS DR
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City | HOUSTON
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State | TX
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Zip | 77066-5127
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Country | US
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Telephone |
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | IL
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