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NPI Code Detail

MEDICARE: TIFFANY ALLYSON ANTHONY MD

MEDICARE: TIFFANY ALLYSON ANTHONY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036176376IL

General Provider Information

NPI Number : 1386376044
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY ALLYSON ANTHONY MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 2210 W 95TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1002
Country : US
Telephone Number : 773-341-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2022
Last Update Date : 12/09/2025

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Directions to “ TIFFANY ALLYSON ANTHONY MD” Practice Location

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