Tillman, Anita M.
Tillman, Anita M. is an individual health care provider with primary practice located at 1302 Franklin Ave Suite 2500, Normal IL 61761-3551. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Tillman, Anita M. can be contacted via phone (309) 268-2770.Contact Information
Primary practice address
1302 Franklin Ave Suite 2500
Normal IL 61761-3551
Phone: (309) 268-2770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036084299 | Illinois |
Profile Details
| NPI number | 1821016502 |
|---|---|
| LBN Legal business name | Tillman, Anita M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Dec 27th, 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 | 1821016502 | NPPES |
| Illinois | MEDICAID | 036084299 | |
| Illinois | Other | 5723019 |
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