SearchIllinois104100000X

Tiana Avery

NPI 1366209710 · on the registry since 2024 · sole proprietor

Practice

Address
1018 W 115th St
Chicago, IL 60643
Phone
(773) 272-5614

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-03-04

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