Provider Demographics
NPI:1497588347
Name:ARIYO, TIKA A
Entity type:Individual
Prefix:MS
First Name:TIKA
Middle Name:A
Last Name:ARIYO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TIKA
Other - Middle Name:A
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:543 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1533
Mailing Address - Country:US
Mailing Address - Phone:708-368-1353
Mailing Address - Fax:
Practice Address - Street 1:543 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1533
Practice Address - Country:US
Practice Address - Phone:708-368-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist