Provider Demographics
NPI:1861738411
Name:THOMPKINS, TIFFANY D (MS, NP-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:D
Last Name:THOMPKINS
Suffix:
Gender:F
Credentials:MS, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7037 S STONY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1905
Mailing Address - Country:US
Mailing Address - Phone:312-355-5590
Mailing Address - Fax:
Practice Address - Street 1:7037 S STONY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-1905
Practice Address - Country:US
Practice Address - Phone:312-355-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily