Provider Demographics
NPI:1447519111
Name:FURUMI, TENSHI (MA, ATC)
Entity type:Individual
Prefix:MR
First Name:TENSHI
Middle Name:
Last Name:FURUMI
Suffix:
Gender:M
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE UNIVERSITY PLAZA, UNIV. OF ILLINOIS-SPRINGFIELD
Mailing Address - Street 2:MS REC 2004
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703
Mailing Address - Country:US
Mailing Address - Phone:217-206-7597
Mailing Address - Fax:217-206-7111
Practice Address - Street 1:ONE UNIVERSITY PLAZA, UNIV. OF ILLINOIS-SPRINGFIELD
Practice Address - Street 2:MS REC 2004
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703
Practice Address - Country:US
Practice Address - Phone:217-206-7597
Practice Address - Fax:217-206-7111
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0037042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000003658OtherNATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION