Individual
DR. CHAD TATTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2502 E EMPIRE ST, SUITE C, BLOOMINGTON, IL 61704-3738
(309) 664-1007
(309) 664-5006
Mailing address
2502 E EMPIRE ST, SUITE C, BLOOMINGTON, IL 61704-3738
(309) 664-1007
(309) 664-5006
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
IL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094439
HEALTH ALLIANCE
IL
01
—
5732052
BLUE CROSS BLUE SHIELD
IL
01
—
681561
HEALTH LINK
IL
01
—
P00169439
RURAL MEDICARE
IL
Enumeration date
07/14/2006
Last updated
09/10/2007
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