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NPI Code Detail

MEDICARE: DR. TIFFANY MING KAO D.C.

MEDICARE: DR. TIFFANY MING KAO D.C.
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
1111N00000XChiropractor38010890IL

General Provider Information

NPI Number : 1629116462
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY MING KAO D.C.
Provider Business Mailing Address
First Line : 4579 180TH ST
Second Line :
City : CLINTON
State : IA
Zip : 52732-8747
Country : US
Telephone Number : 815-273-5022
Fax Number : 815-273-5023
Provider Business Practice Location Address
First Line : 202 MAIN ST
Second Line :
City : SAVANNA
State : IL
Zip : 61074-1628
Country : US
Telephone Number : 815-273-5022
Fax Number : 815-273-5023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 07/08/2007

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