Provider Demographics
NPI:1487326815
Name:MCGUINN, TONIA ELIZABETH (LMT, CPT)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:ELIZABETH
Last Name:MCGUINN
Suffix:
Gender:F
Credentials:LMT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-2138
Mailing Address - Country:US
Mailing Address - Phone:815-513-5686
Mailing Address - Fax:
Practice Address - Street 1:105 E MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-2138
Practice Address - Country:US
Practice Address - Phone:815-513-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.016006225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL227.016006OtherLICENSE NUMBER