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NPI Code Detail

MEDICARE: MRS. TIFFANY D THOMPKINS M.S., NP-C

MEDICARE: MRS. TIFFANY D THOMPKINS M.S., NP-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
1363LF0000XFamily Nurse Practitioner209.009439IL

General Provider Information

NPI Number : 1861738411
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY D THOMPKINS M.S., NP-C
Provider Business Mailing Address
First Line : 7037 S STONY ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1905
Country : US
Telephone Number : 312-355-5590
Fax Number :
Provider Business Practice Location Address
First Line : 7037 S STONY ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1905
Country : US
Telephone Number : 312-355-5590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2012
Last Update Date : 11/17/2018

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