Individual
TIFFANY JEAN VAJDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 W NORTH AVE, MELROSE PARK, IL 60160-1612
(708) 681-3200
Mailing address
1121 LAKE COOK RD STE M, DEERFIELD, IL 60015-5234
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041334424
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209007429
IL
Other
Enumeration date
12/22/2008
Last updated
10/02/2017
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