Individual
TIA CONSOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6712 N CONVENT ST, BOURBONNAIS, IL 60914-1528
(815) 928-8050
(815) 928-8932
Mailing address
900 RAND RD STE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
09/13/2024
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