Provider Demographics
NPI:1942980032
Name:BECERRA ALWAZAN, TIFFANI (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:TIFFANI
Middle Name:
Last Name:BECERRA ALWAZAN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-3325
Mailing Address - Country:US
Mailing Address - Phone:630-447-9847
Mailing Address - Fax:
Practice Address - Street 1:929 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3325
Practice Address - Country:US
Practice Address - Phone:630-447-9857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2200120175F00000X
IL198.001625171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath