Provider Demographics
NPI:1326285503
Name:DAUTI, TAULANT (CSA)
Entity Type:Individual
Prefix:
First Name:TAULANT
Middle Name:
Last Name:DAUTI
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1990 E ALGONQUIN RD
Mailing Address - Street 2:SUITE #160
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4173
Mailing Address - Country:US
Mailing Address - Phone:847-303-1200
Mailing Address - Fax:847-303-1210
Practice Address - Street 1:1990 E ALGONQUIN RD
Practice Address - Street 2:SUITE 160
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4173
Practice Address - Country:US
Practice Address - Phone:847-303-1200
Practice Address - Fax:847-303-1210
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2011-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL08-260363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical