Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 125.064955 | IL |
N | 208600000X | Surgeon | 125.064955 | IL |
Y | 2086S0129X | Vascular Surgeon | 036.149554 | IL |
NPI | 1013322973 |
---|---|
Provider Name | Nader Tehrani |
First Address | Arlington Heights, IL 60005-2379 |
Second Address | Arlington Heights, IL 60005-2379 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2014 |
Last Update Date | 10/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036110448 | STATE LICENSE (01) | IL |