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General NPI Number Information
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NPI Number | 1730474685
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Entity Type | Individual
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Provider Name | ANJAN TIBREWALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 259 E ERIE ST
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City | CHICAGO
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State | IL
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Zip | 60611-2987
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Country | US
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Telephone | 312-926-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 676 N SAINT CLAIR ST SUITE 600
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City | CHICAGO
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State | IL
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Zip | 60611-2927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036134900
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2011017889
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036134900
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036134900
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 036134900
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License Number State | IL
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