Provider Demographics
NPI:1679561484
Name:CHAPMAN, TAMMI LEE (DPM)
Entity Type:Individual
Prefix:DR
First Name:TAMMI
Middle Name:LEE
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MRS
Other - First Name:TAMMI
Other - Middle Name:LEE
Other - Last Name:HOUT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-0185
Mailing Address - Country:US
Mailing Address - Phone:618-546-2591
Mailing Address - Fax:
Practice Address - Street 1:1000 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:IL
Practice Address - Zip Code:62454-1167
Practice Address - Country:US
Practice Address - Phone:618-546-2591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004774213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5180750001Medicare NSC
ILU66705Medicare UPIN
IL273950Medicare ID - Type Unspecified