Provider Demographics
NPI:1477655488
Name:TAMBAR, SIDDHARTH (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDDHARTH
Middle Name:
Last Name:TAMBAR
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 1:618 W FULTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1144
Mailing Address - Country:US
Mailing Address - Phone:773-348-7171
Mailing Address - Fax:773-347-7414
Practice Address - Street 1:618 W FULTON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-1144
Practice Address - Country:US
Practice Address - Phone:773-348-7171
Practice Address - Fax:737-348-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-111655207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine