Individual
BILLY TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1436 W. RANDOLPH, 5TH FLOOR, CHICAGO, IL 60607
(312) 226-8720
(312) 226-8722
Mailing address
1436 W RANDOLPH ST, 5TH FLOOR, CHICAGO, IL 60607-1405
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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