Provider Demographics
NPI:1316184617
Name:TABRIZI, RANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RANNA
Middle Name:
Last Name:TABRIZI
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 1:40 N TOWER RD
Mailing Address - Street 2:APT 8L
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1155
Mailing Address - Country:US
Mailing Address - Phone:630-649-8620
Mailing Address - Fax:
Practice Address - Street 1:40 N TOWER RD
Practice Address - Street 2:APT 8L
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1155
Practice Address - Country:US
Practice Address - Phone:630-649-8620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119942208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery