Individual
JESSICA TINIANOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3100 N LAKE SHORE DR, 1108, CHICAGO, IL 60657-4946
(773) 551-1226
Mailing address
3100 N LAKE SHORE DR, 1108, CHICAGO, IL 60657-4946
(773) 551-1226
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036081623
IL
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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