Abrego, Tiffany
Abrego, Tiffany is an individual health care provider with primary practice located at 900 Main St Ste 720 , Peoria IL 61602-5027. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Abrego, Tiffany can be contacted via phone (309) 495-1640.Contact Information
Primary practice address
900 Main St Ste 720
Peoria IL 61602-5027
Phone: (309) 495-1640
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 071.009388 | Illinois |
Profile Details
| NPI number | 1114320413 |
|---|---|
| LBN Legal business name | Abrego, Tiffany |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2014 |
| Last updated | Jan 11th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114320413 | NPPES |
| Illinois | MEDICAID | 071.009388 |
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