Individual
TIFFANNY M CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
427 W NORTHMOOR RD, PEORIA, IL 61614-3542
(309) 692-5337
(309) 693-3913
Mailing address
427 W NORTHMOOR RD, PEORIA, IL 61614-3542
(309) 692-5337
(309) 693-3913
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
385002364
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400773279
MEDICARE
IL
Enumeration date
06/10/2010
Last updated
10/21/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us