Individual
TIFFANY LEIA COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MBA
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 942-5000
Mailing address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125.081147
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
05/19/2023
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