Watt, Tiffany A
Watt, Tiffany A is an individual health care provider with primary practice located at 9550 W 167Th St , Orland Park IL 60467-5561. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Watt, Tiffany A can be contacted via phone (708) 873-4500.Contact Information
Primary practice address
9550 W 167Th St
Orland Park IL 60467-5561
Phone: (708) 873-4500
Fax: (708) 873-4505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085002118 | Illinois |
Profile Details
| NPI number | 1528166337 |
|---|---|
| LBN Legal business name | Watt, Tiffany A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Dec 21st, 2021 - about 4 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 | 1528166337 | NPPES |
| Illinois | Other | 085-002118 | ILLINOIS STATE LICENSE |
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