Provider Demographics
NPI:1659268126
Name:TONI, TAHLIA ALEXANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:TAHLIA
Middle Name:ALEXANDRA
Last Name:TONI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 N BELL AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5473
Mailing Address - Country:US
Mailing Address - Phone:847-373-9073
Mailing Address - Fax:
Practice Address - Street 1:1531 S GROVE AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5250
Practice Address - Country:US
Practice Address - Phone:847-381-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant