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NPI Code Detail

MEDICARE: ZAHRA TAHIR OD

MEDICARE: ZAHRA TAHIR OD
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
1152W00000XOptometrist046011569IL

General Provider Information

NPI Number : 1396411195
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZAHRA TAHIR OD
Provider Business Mailing Address
First Line : 8309 N KNOXVILLE AVE
Second Line :
City : PEORIA
State : IL
Zip : 61615-2170
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8309 N KNOXVILLE AVE
Second Line :
City : PEORIA
State : IL
Zip : 61615-2170
Country : US
Telephone Number : 309-693-9540
Fax Number : 309-693-9542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2021
Last Update Date : 08/20/2021

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Directions to “ ZAHRA TAHIR OD” Practice Location

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