Doctor Name: | TANVIR MUSHTAQ |
NPI Number: | 1659700318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 036133420 |
Business Practice Address: | 2055 W Army Trail Rd #104 Addison, IL - 601011478 |
Business Phone Number: | 6305995400 |
Business Fax Number: | |
Mailing Address: | 2055 W Army Trail Rd, #104 ADDISON |
State: | IL |
Postal Code: | 601011478 |
Phone Number: | 6305995400 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2013 |
NPI Last Update Date: | 11/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036133420 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |