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General NPI Number Information
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NPI Number | 1861738411
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Entity Type | Individual
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Provider Name | TIFFANY D THOMPKINS M.S., NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 11/17/2018
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Provider Practice Location Address
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Address Line | 7037 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60649-1905
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Country | US
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Telephone | 312-355-5590
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Fax |
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Provider Business Mailing Address
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Address Line | 7037 S STONY ISLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60649-1905
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Country | US
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Telephone | 312-355-5590
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.009439
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License Number State | IL
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