MEDICARE: JOHN JOSEPH TAGLIA 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	2084P0800X	Psychiatry Physician	036161593	IL

General Provider Information

NPI Number	:	1841221173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JOSEPH TAGLIA MD

Provider Business Mailing Address
First Line	:	1401 NILES AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-1584
Country	:	US
Telephone Number	:	773-531-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	7808 W COLLEGE DR STE 2W
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1098
Country	:	US
Telephone Number	:	708-631-5110
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/10/2022

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