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General NPI Number Information
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NPI Number | 1821944877
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Entity Type | Organization
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Legal Business Name | TUMMY VISION LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 344 HARRISON ST
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City | OAK PARK
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State | IL
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Zip | 60304-1587
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Country | US
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Telephone | 833-338-8669
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Fax |
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Provider Business Mailing Address
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Address Line | 6037 S NORMANDY AVE
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City | CHICAGO
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State | IL
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Zip | 60638-4119
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Country | US
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Telephone | 833-338-8669
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL PAUL STAESCHE
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Credential |
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Telephone | 773-706-2637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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