Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 125076425 | IL |
NPI | 1023632650 |
---|---|
Provider Name | Reza Zayn Tanveer |
First Address | Chicago, IL 60612-3801 |
Second Address | Chicago, IL 60612-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2020 |
Last Update Date | 29/05/2020 |