Tiffany Lavera Jones-Evans

Individual provider Active NPI Registered Nurse · Riverdale, IL

NPI 1306272000 · NPPES record last updated Sep 25, 2013

Key facts

NPI
1306272000
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
041-415093 (IL)
Practice address
14414 S Union Ave
Riverdale, IL 60827-2636
Phone
(773) 317-0957
NPI assigned
Sep 25, 2013
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

State licenses

LicenseStateTypeSpecialty
041-415093ILMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-415093 IL Yes

Addresses

Primary practice location

14414 S Union Ave
Riverdale, IL 60827-2636

Mailing address

14414 S Union Ave
Riverdale, IL 60827-2636
Phone (773) 317-0957

Other providers in Riverdale, IL

All providers in Riverdale, IL · Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.