Healthcare Provider Details

I. General information

NPI: 1639011778
Provider Name (Legal Business Name): NIRMEEN TAHIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3057 W CERMAK RD
CHICAGO IL
60623-3548
US

IV. Provider business mailing address

7220 FAIRMOUNT AVE
DOWNERS GROVE IL
60516-3932
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-0200
  • Fax: 773-257-0227
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.037240
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: