MEDICARE: MANISH TANNA 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	207RN0300X	Nephrology Physician	036096147	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1616108	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1821096470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANISH TANNA MD

Provider Business Mailing Address
First Line	:	120 W 22ND ST STE 200
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1563
Country	:	US
Telephone Number	:	630-573-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W GOLF RD STE 105
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4276
Country	:	US
Telephone Number	:	847-439-8780
Fax Number	:	847-439-8940

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	04/28/2025

Similar Medicare Providers

1922119643 — EVGUENI MINEV M.D.
Practice Location Address:

601 W GOLF RD STE 105
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-439-8780
Practice Fax: 847-439-8940

1376728113 — DR. VENKATA Y BEHARA MD
Practice Location Address:

601 W GOLF RD , SUITE 105
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-298-0600
Practice Fax: 847-298-6395

1114191632 — ANDREW MICHAEL PECK MD
Practice Location Address:

601 W GOLF RD STE 105 , NEPHROLOGY ASSOC. OF NORTHERN ILLINOIS
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-439-8780
Practice Fax: 847-298-6395

1821381500 — COLLEEN ANN SCHOLL NP
Practice Location Address:

601 W GOLF RD STE 105
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-439-8780
Practice Fax: 847-439-8940

1740544857 — DR. DELIN WANG M.D.
Practice Location Address:

601 W GOLF RD STE 105
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-439-8780
Practice Fax:

1518386911 — DR. SHEN SONG MD
Practice Location Address:

601 W GOLF RD STE 105
MOUNT PROSPECT, IL
60056-4276

Practice Phone: 847-439-8780
Practice Fax:

Directions to “ MANISH TANNA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.