Individual
TIFFANI GANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHIATRIC MENTAL H
Contact information
Practice address
440 W BOUGHTON RD STE E, BOLINGBROOK, IL 60440-2391
(815) 278-0404
Mailing address
24541 S MOORMAN AVE, CHANNAHON, IL 60410-9793
(815) 278-0404
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209033896
IL
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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