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NPI Code Detail

MEDICARE: MISS TIFFANY ATHEY MSN, APN

MEDICARE: MISS TIFFANY ATHEY MSN, APN
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
1363LW0102XWomen's Health Nurse Practitioner209-003645IL

General Provider Information

NPI Number : 1902801293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TIFFANY ATHEY MSN, APN
Provider Business Mailing Address
First Line : PO BOX 1008
Second Line :
City : NORTHBROOK
State : IL
Zip : 60065-1008
Country : US
Telephone Number : 312-558-6481
Fax Number : 312-762-3919
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 300
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4495
Country : US
Telephone Number : 312-558-6481
Fax Number : 312-762-3919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 10/25/2023

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