Doctor Name: | MR. KENNETH A. STIFF |
NPI Number: | 1255300117 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC |
License Number: | 96000134 |
Business Practice Address: | 500 W Elk Grove Blvd Elk Grove Village, IL - 600074272 |
Business Phone Number: | 8477184412 |
Business Fax Number: | 8477184417 |
Mailing Address: | 2904 South Ct, ROLLING MEADOWS |
State: | IL |
Postal Code: | 600081757 |
Phone Number: | 8473943492 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225500000X |
License Number: | 96000134 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |