Search › Illinois › 222Q00000X
Tiffany Wallace
NPI 1720991987 · on the registry since 2026
Practice
- Address
- 2312 S 23rd Ave
Broadview, IL 60155 - Phone
- (708) 299-3769
Registry record
- Primary taxonomy
- 222Q00000X
222Q00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-09-28
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