Tamika St. Clair
Individual provider Active NPI Developmental Therapist · Evergreen PK, IL
NPI 1174066567 · NPPES record last updated Dec 2, 2016
Key facts
- NPI
- 1174066567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 2936 W 97TH PL
Evergreen PK, IL 60805-2608 - Phone
- (312) 647-5712
- NPI assigned
- Dec 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
2936 W 97TH PL
Evergreen PK, IL 60805-2608
Mailing address
2936 W 97TH PL
Evergreen PK, IL 60805-2608
Phone (312) 647-5712
Other providers in Evergreen PK, IL
- Chiquita Lee
- N'Courage Counseling and Consultation Services, PLLC
- Deborah Olubukunola Oyelowo
- Antoinette Sallamme
- Servant of Peace LLC
- Unicolive Home Healthcare Services Inc
All providers in Evergreen PK, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.