Provider Demographics
NPI:1205113198
Name:TORRES, TIANA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:TIANA
Middle Name:LYNN
Last Name:TORRES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36735 N IL 83
Mailing Address - Street 2:STE D
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046
Mailing Address - Country:US
Mailing Address - Phone:478-265-5600
Mailing Address - Fax:847-245-4491
Practice Address - Street 1:36735 N IL ROUTE 83 STE D
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-9621
Practice Address - Country:US
Practice Address - Phone:847-265-5600
Practice Address - Fax:847-245-4491
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861894081OtherNPPES