Provider Demographics
NPI:1518236660
Name:TIBERI, CATHERINE
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:TIBERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 LARKIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-6042
Mailing Address - Country:US
Mailing Address - Phone:847-608-2682
Mailing Address - Fax:847-608-2689
Practice Address - Street 1:1212 LARKIN AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6042
Practice Address - Country:US
Practice Address - Phone:847-608-2682
Practice Address - Fax:847-608-2689
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor