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General NPI Number Information
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NPI Number | 1902879778
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Entity Type | Individual
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Provider Name | TAMARA ISAKOVA MD
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Gender | Female
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 633 N SAINT CLAIR ST 18TH FLOOR ROOM 18-083
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City | CHICAGO
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State | IL
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Zip | 60611-3234
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Country | US
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Telephone | 312-503-6921
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Fax | 312-503-5656
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Provider Business Mailing Address
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Address Line | 633 N SAINT CLAIR ST 18TH FLOOR ROOM 18-083
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City | CHICAGO
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State | IL
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Zip | 60611-3234
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Country | US
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Telephone | 312-503-6921
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Fax | 312-503-5656
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 107174
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License Number State | FL
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