Individual
TIFFANY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5322 S KIMBARK AVE APT 1N, CHICAGO, IL 60615-5232
(312) 363-9869
Mailing address
5322 S KIMBARK AVE APT 1N, CHICAGO, IL 60615-5232
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.472068
IL
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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