Provider Demographics
NPI:1972144541
Name:DURR, TAMMIE AREATHA
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:AREATHA
Last Name:DURR
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 1:310 LATHROP AVE APT 603
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-1480
Mailing Address - Country:US
Mailing Address - Phone:708-692-5350
Mailing Address - Fax:
Practice Address - Street 1:310 LATHROP AVE APT 603
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-1480
Practice Address - Country:US
Practice Address - Phone:708-692-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist