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NPI Code Detail

MEDICARE: TAHIR NIAZI, MD SC

MEDICARE: TAHIR NIAZI, MD SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician036087267IL

General Provider Information

NPI Number : 1669590063
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAHIR NIAZI, MD SC
Provider Business Mailing Address
First Line : 6020 W DIVERSEY AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1108
Country : US
Telephone Number : 773-237-5544
Fax Number : 773-889-0883
Provider Business Practice Location Address
First Line : 6020 W DIVERSEY AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1108
Country : US
Telephone Number : 773-237-5544
Fax Number : 773-889-0883
Authorized Official
Title or Position : PRESIDENT
Name : DR. TAHIR NIAZI
Credential : MD
Telephone Number : 773-237-5544
Provider Enumeration Date : 03/26/2007
Last Update Date : 01/30/2013

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