Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.145273 | IL |
N | 111NI0900X | Internist | 036.145273 | IL |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036.145273 | IL |
N | 2080P0205X | Pediatric Endocrinologist | 036.145273 | IL |
NPI | 1003233164 |
---|---|
Provider Name | Tara Rajiyah |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 14/10/2019 |