Individual
MISS TIFFANI CHERHYS STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4939 S DORCHESTER AVE APT 5C, CHICAGO, IL 60615-2871
(708) 668-6850
Mailing address
4939 S DORCHESTER AVE APT 5C, CHICAGO, IL 60615-2871
(708) 668-6850
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003927
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085003927
—
IL
Enumeration date
01/09/2011
Last updated
06/16/2022
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