Individual provider Active NPI

Sasah Irene Tillman, LMFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1982914263
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166000804 Issued in IL
Practice address
4334 N Hazel St
Apt 1308
Chicago, IL 60613-1434
Phone
(815) 557-6478
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000804 IL Primary

Addresses

Primary practice location

4334 N Hazel St
Apt 1308
Chicago, IL 60613-1434

Mailing address

4334 N Hazel St
Apt 1308
Chicago, IL 60613-1434
Phone (815) 557-6478

Other names 1

  • Sasah Irene Tillman Richardson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
166000804ILMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1982914263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 N HAZEL ST",
            "address_2": "APT 1308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131434",
            "telephone_number": "815-557-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4334 N HAZEL ST",
            "address_2": "APT 1308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131434",
            "telephone_number": "815-557-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "SASAH",
        "middle_name": "IRENE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SASAH",
            "last_name": "TILLMAN RICHARDSON",
            "middle_name": "IRENE",
            "credential": "LMFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.