Basic Information
Provider Information
NPI: 1679561484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: TAMMI
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOUT
OtherFirstName: TAMMI
OtherMiddleName: LEE
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: PO BOX 185
Address2:  
City: OLNEY
State: IL
PostalCode: 624500185
CountryCode: US
TelephoneNumber: 6185462591
FaxNumber:  
Practice Location
Address1: 1000 N ALLEN ST
Address2:  
City: ROBINSON
State: IL
PostalCode: 624541167
CountryCode: US
TelephoneNumber: 6185462591
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/06/2005
LastUpdateDate: 08/19/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000X016-004774ILY Podiatric Medicine & Surgery Service ProvidersPodiatrist 

No ID Information.


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