Provider Demographics
NPI:1386897205
Name:TIRIMACCO, PHILIP SAMUEL (PROSTHETIST)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:SAMUEL
Last Name:TIRIMACCO
Suffix:
Gender:M
Credentials:PROSTHETIST
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Mailing Address - Street 1:5000 S 5TH AVE
Mailing Address - Street 2:PROSTHETIC SENSORY AIDS 121-B
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141-3030
Mailing Address - Country:US
Mailing Address - Phone:708-202-8387
Mailing Address - Fax:708-202-2008
Practice Address - Street 1:5000 S 5TH AVE
Practice Address - Street 2:PROSTHETIC SENSORY AIDS 121-B
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141-3030
Practice Address - Country:US
Practice Address - Phone:708-202-8387
Practice Address - Fax:708-202-2008
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist