MEDICARE: TALEB NASSRI MD

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
1	207R00000X	Internal Medicine Physician	125.086885	IL

General Provider Information

NPI Number	:	1295539047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALEB NASSRI MD

Provider Business Mailing Address
First Line	:	1427 KENSINGTON DR
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-3248
Country	:	US
Telephone Number	:	239-297-0334
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 S MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-2315
Country	:	US
Telephone Number	:	312-567-2397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	12/03/2025

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