MEDICARE: ARISS TIFFANI PIERCE DPT

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
1	225100000X	Physical Therapist	070025301	IL

General Provider Information

NPI Number	:	1407116080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARISS TIFFANI PIERCE DPT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	630-575-1980
Fax Number	:	630-928-5080

Provider Business Practice Location Address
First Line	:	555 E TOWNLINE RD STE 24
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-1552
Country	:	US
Telephone Number	:	847-573-0051
Fax Number	:	847-573-0345

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	02/18/2025

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