MEDICARE: SARA TUFFS

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1417482878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA TUFFS

Provider Business Mailing Address
First Line	:	1915 S RACINE AVE
Second Line	:	APT 1
City	:	CHICAGO
State	:	IL
Zip	:	60608-3980
Country	:	US
Telephone Number	:	815-353-9424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 S RACINE AVE
Second Line	:	APT 1
City	:	CHICAGO
State	:	IL
Zip	:	60608-3980
Country	:	US
Telephone Number	:	815-353-9424
Fax Number	:

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

Provider Enumeration Date	:	04/24/2017
Last Update Date	:	04/24/2017

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Directions to “ SARA TUFFS ” Practice Location

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