Individual
MS. TIFFANY NICOLE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
219 W CHICAGO AVE STE 200, CHICAGO, IL 60654-5600
(832) 761-3176
Mailing address
7432 WASHINGTON ST APT 402, FOREST PARK, IL 60130-1533
(708) 805-3721
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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