Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125065633 | IL |
N | 111NI0900X | Internist | 125065633 | IL |
Y | 207RC0000X | Internist - Cardiovascular Disease | 01083033A | IN |
NPI | 1023423845 |
---|---|
Provider Name | Mr. Rana Zouveenoor Tariq |
First Address | Chicago, IL 60612-3800 |
Second Address | Bloomington, IN 47403-2089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 23/11/2020 |