IndividualActive
Autumn Tatman
NPI 1487389581 · Dental Hygienist · Champaign, IL
Provider details
- NPI number
- 1487389581
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 020.015266 (IL)
Specialties & taxonomies
Dental Providers
Practice location
201 W Kenyon Rd
Champaign, IL 61820-7892
Phone: (217) 531-4279
Approximate (ZIP-level) locationGet directions
Mailing address
201 W Kenyon Rd
Champaign, IL 61820-7892
Registry dates
- Enumerated
- 2022-07-21
- Last updated
- 2022-07-21
- Certified
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.