Provider Demographics
NPI:1164453783
Name:HANIF, TABASSUM (MD)
Entity Type:Individual
Prefix:DR
First Name:TABASSUM
Middle Name:
Last Name:HANIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1200
Mailing Address - Country:US
Mailing Address - Phone:708-274-4900
Mailing Address - Fax:708-274-4949
Practice Address - Street 1:11900 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1200
Practice Address - Country:US
Practice Address - Phone:708-274-4900
Practice Address - Fax:708-274-4949
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120489207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00707902OtherMEDICARE RAILROAD
IL036120489Medicaid
IL036120489Medicaid
ILR01848Medicare PIN
IL036120489Medicaid