Provider Demographics
NPI:1881370161
Name:DORSEY, TANIA LORETTA
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:LORETTA
Last Name:DORSEY
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 1:1213 KINGS CT APT 38
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-4328
Mailing Address - Country:US
Mailing Address - Phone:630-779-7130
Mailing Address - Fax:
Practice Address - Street 1:1213 KINGS CT APT 38
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-4328
Practice Address - Country:US
Practice Address - Phone:630-779-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)