Provider Demographics
NPI:1689916058
Name:TAJUDDIN, AAMAIR (DO)
Entity Type:Individual
Prefix:
First Name:AAMAIR
Middle Name:
Last Name:TAJUDDIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 SCHOOL ST STE A
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1207
Mailing Address - Country:US
Mailing Address - Phone:815-705-1405
Mailing Address - Fax:815-941-4363
Practice Address - Street 1:4 E NORTH ST
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1087
Practice Address - Country:US
Practice Address - Phone:815-518-5755
Practice Address - Fax:815-705-1718
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036139508208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program