Provider Demographics
NPI:1790993608
Name:CUMMINGS, TARA (DT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:SZOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-412-4350
Mailing Address - Fax:847-983-0687
Practice Address - Street 1:255 REVERE DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-412-4350
Practice Address - Fax:847-983-0687
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist