Healthcare Provider Details

I. General information

NPI: 1427215680
Provider Name (Legal Business Name): TOHFA MANJI RUDA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOHFA AMIN MANJI D.O.

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W. 95TH STREET, OUTPATIENT PAVILION 8TH FLOOR
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-9560
  • Fax: 708-520-3002
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number036.125989
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.125989
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number036.125989
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: