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NPI Code Detail

MEDICARE: TATYANA KHOLOD SANDERS

MEDICARE: TATYANA KHOLOD SANDERS
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
1363LF0000XFamily Nurse Practitioner209.010764IL

General Provider Information

NPI Number : 1811326523
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATYANA KHOLOD SANDERS
Provider Business Mailing Address
First Line : 56 W DUNDEE RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-3758
Country : US
Telephone Number : 224-601-5001
Fax Number :
Provider Business Practice Location Address
First Line : 56 W DUNDEE RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-3758
Country : US
Telephone Number : 224-601-5001
Fax Number : 224-333-7063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2013
Last Update Date : 04/06/2026

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Directions to “ TATYANA KHOLOD SANDERS ” Practice Location

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