Individual
TIA T TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2507 W 46TH ST # 2, CHICAGO, IL 60632-1320
(312) 282-7808
Mailing address
2507 W 46TH ST # 2, CHICAGO, IL 60632-1320
(312) 282-7808
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/26/2023
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