Organization
OAK PARK BEHAVIORAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY TAFT PSYD (OWNER)
(312) 725-6175
Entity
Organization
Contact information
Practice address
818 HARRISON ST, SUITE 210, OAK PARK, IL 60304-1144
(312) 725-6175
Mailing address
824 S GROVE AVE, OAK PARK, IL 60304-1125
(312) 725-6175
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008285
IL
Other
Enumeration date
07/14/2012
Last updated
07/14/2012
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