Provider Demographics
NPI:1497723597
Name:TAMAR, LTD.
Entity Type:Organization
Organization Name:TAMAR, LTD.
Other - Org Name:LIFE WOMENS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:ROSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-484-0500
Mailing Address - Street 1:6425 CERMAK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2338
Mailing Address - Country:US
Mailing Address - Phone:708-484-0500
Mailing Address - Fax:708-484-4259
Practice Address - Street 1:6425 CERMAK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2338
Practice Address - Country:US
Practice Address - Phone:708-484-0500
Practice Address - Fax:708-484-4259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622621OtherBLUE CROSS BLUE SHIELD
IL01622621OtherBLUE CROSS BLUE SHIELD