Provider Demographics
NPI:1679990287
Name:DUCATO, TIFFANY (DPT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:DUCATO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16650 HICKORY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-1724
Mailing Address - Country:US
Mailing Address - Phone:630-777-4438
Mailing Address - Fax:
Practice Address - Street 1:16650 HICKORY CREEK CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-1724
Practice Address - Country:US
Practice Address - Phone:630-777-4438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist