| Doctor Name: | DR. EUGENE M TANQUILUT |
| NPI Number: | 1043215148 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 02002492A |
| Business Practice Address: | 20060 Governors Dr Suite 102 Olympia Fields, IL - 604611029 |
| Business Phone Number: | 8158244406 |
| Business Fax Number: | 8158440307 |
| Mailing Address: | 20060 Governors Dr, Suite 102 OLYMPIA FIELDS |
| State: | IL |
| Postal Code: | 604611029 |
| Phone Number: | 8158244406 |
| Fax Number: | 8158440307 |
| NPI Enumeration Date: | 06/15/2005 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | 02002492A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |