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NPI Code Detail

MEDICARE: CORNELIA V. TANDEZ,MD,LTD

MEDICARE: CORNELIA V. TANDEZ,MD,LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023683513
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNELIA V. TANDEZ,MD,LTD
Provider Business Mailing Address
First Line : 8248 W BALLARD RD
Second Line :
City : NILES
State : IL
Zip : 60714-1544
Country : US
Telephone Number : 847-962-0149
Fax Number :
Provider Business Practice Location Address
First Line : 637 E GOLF RD STE 209
Second Line :
City : ARLINGTON HTS
State : IL
Zip : 60005-4070
Country : US
Telephone Number : 847-258-5098
Fax Number : 847-258-5061
Authorized Official
Title or Position : OWNER
Name : CORNELIA TANDEZ
Credential : MD
Telephone Number : 847-962-0149
Provider Enumeration Date : 05/26/2021
Last Update Date : 05/26/2021

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Directions to “CORNELIA V. TANDEZ,MD,LTD ” Practice Location

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