Tina Adlam, L.M.T.

Individual provider Active NPI Massage Therapist · Flossmoor, IL

NPI 1386987121 · NPPES record last updated Mar 29, 2013

Key facts

NPI
1386987121
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
227015353 (IL)
Practice address
3329 Vollmer Rd
Flossmoor, IL 60422-2003
Phone
(708) 206-2750
NPI assigned
Mar 29, 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
227015353ILMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227015353 IL Yes

Addresses

Primary practice location

3329 Vollmer Rd
Flossmoor, IL 60422-2003

Mailing address

582 Ranger Dr
Chicago Heights, IL 60411-1911
Phone (708) 205-5185

Other identifiers

IdentifierTypeStateIssuer
227015353OtherILSTATE LICENSE

Other providers in Flossmoor, IL

All providers in Flossmoor, IL · Massage Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.