Physician Compare National (NPI:1962847129)

HEALTHCARE PROVIDER: TAHREEM S AZIZ DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1962847129
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002058666
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160906000108
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AZIZ
	Individual professional last name
Provider First Name	TAHREEM
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERVENTIONAL PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	OSTEOPATHIC MANIPULATIVE MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERVENTIONAL PAIN MANAGEMENT, OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SOUND PHYSICIANS OF ILLINOIS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1557533734
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	52
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	12303 DE PAUL DR
	Group Practice or individual's line 1 address
City	BRIDGETON
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	630442512
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3143446000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260104
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SSM DEPAUL HEALTH CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHRISTIAN HOSPITAL NORTHEAST
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y