Search › Illinois › 374J00000X
Tisha Gatson
NPI 1043007909 · on the registry since 2025 · sole proprietor
Practice
- Address
- 2406 Autumn Oak Ct
Champaign, IL 61822 - Phone
- (217) 766-2650
Additional practice sites
- 503 S Country Fair Dr Ste 2a, Champaign, IL
Registry record
- Primary taxonomy
- 374J00000X
374J00000X
- Also registered as
- 174N00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-04-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois