Individual
MISS TAMARA A. PRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 E TERRA COTTA AVE STE 125, CRYSTAL LAKE, IL 60014
(815) 455-4434
(815) 455-4593
Mailing address
820 E TERRA COTTA AVE, STE 125, CRYSTAL LAKE, IL 60014-3650
(847) 842-8839
(847) 392-8439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001795
IL
Other
Enumeration date
04/12/2007
Last updated
05/24/2018
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