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Individual
WAYNE A TILLMAN
Active
Individual
WAYNE A TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004926
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1626136
BCBS
IL
01
—
2700614
UHC
IL
01
—
480034104
RAILROAD MC
IL
01
—
4861340001
DMGRC
IL
Enumeration date
11/22/2006
Last updated
11/01/2013
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