Provider Demographics
NPI:1558046060
Name:TARBELL, AARON (DPM)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:TARBELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S MAPLE AVE STE 2550
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2807
Mailing Address - Country:US
Mailing Address - Phone:708-660-6100
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE STE 2550
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2807
Practice Address - Country:US
Practice Address - Phone:708-660-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135.001185207X00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery