Provider Demographics
NPI:1932382843
Name:HUNTER, TIFFANY D (PT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:D
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:D
Other - Last Name:CLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2S503 DOGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1327
Mailing Address - Country:US
Mailing Address - Phone:773-398-0382
Mailing Address - Fax:
Practice Address - Street 1:2S503 DOGWOOD CT
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-1327
Practice Address - Country:US
Practice Address - Phone:773-398-0382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist