Provider Demographics
NPI:1104025139
Name:ROHAIL, TAHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:TAHIR
Middle Name:
Last Name:ROHAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 ROBERT LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-7126
Mailing Address - Country:US
Mailing Address - Phone:708-415-7459
Mailing Address - Fax:708-447-2104
Practice Address - Street 1:2910 HARLEM AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1785
Practice Address - Country:US
Practice Address - Phone:708-447-4267
Practice Address - Fax:708-447-2104
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087235207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK21351Medicare PIN