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NPI Code Detail

MEDICARE: DR. TIFFANY L TIBERI PSY.D.

MEDICARE:  DR. TIFFANY L TIBERI  PSY.D.
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
1103TC0700XClinical Psychologist071007799IL

General Provider Information

NPI Number : 1700142460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY L TIBERI PSY.D.
Provider Business Mailing Address
First Line : 3166 N LINCOLN AVE STE 314
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3119
Country : US
Telephone Number : 630-404-8460
Fax Number :
Provider Business Practice Location Address
First Line : 3166 N LINCOLN AVE STE 314
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3119
Country : US
Telephone Number : 773-372-6027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2012
Last Update Date : 12/10/2023

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Directions to “ DR. TIFFANY L TIBERI PSY.D.” Practice Location

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