Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.131832 | IL |
N | 111NI0900X | Internist | 036.131832 | IL |
N | 207R00000X | Internist | 28019 | OK |
N | 111NI0900X | Internist | 28019 | OK |
N | 207RG0300X | Geriatric Medicine | 036.131832 | IL |
N | 207RG0300X | Geriatric Medicine | 28019 | OK |
NPI | 1154658292 |
---|---|
Provider Name | Munish Taneja |
First Address | Evanston, IL 60201-1718 |
Second Address | Evanston, IL 60201-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2009 |
Last Update Date | 27/05/2020 |