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General NPI Number Information
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NPI Number | 1841947371
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Entity Type | Organization
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Legal Business Name | RIZVI TIERNAN PODIATRY PC
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 3675 DARLENE CT STE B
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City | AURORA
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State | IL
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Zip | 60504-6523
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Country | US
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Telephone | 630-415-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 PEYTON TER
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City | SHOREWOOD
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State | IL
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Zip | 60404-1220
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Country | US
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Telephone | 630-202-0319
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ZAIN RIZVI
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Credential | DPM
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Telephone | 630-202-0319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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