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NPI Code Detail

MEDICARE: TANGTANG ZHAO

MEDICARE:   TANGTANG  ZHAO
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
1183500000XPharmacist051.301150IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1051.301150OTHERILIDFPR

General Provider Information

NPI Number : 1174137129
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANGTANG ZHAO
Provider Business Mailing Address
First Line : 9148 S COMMERCIAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60617-4307
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9148 S COMMERCIAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60617-4307
Country : US
Telephone Number : 773-721-6603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2020
Last Update Date : 09/06/2020

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Directions to “ TANGTANG ZHAO ” Practice Location

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