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Individual

TAMIKA L PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4137 SAUK TRL STE 153, RICHTON PARK, IL 60471-1253
(708) 752-6620
Mailing address
4137 SAUK TRL STE 153, RICHTON PARK, IL 60471-1253
(708) 752-6620

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
881739241
IL
Enumeration date
05/15/2022
Last updated
05/15/2022
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