Provider Demographics
NPI:1710150115
Name:JOSHI, TAPAN (MD)
Entity Type:Individual
Prefix:
First Name:TAPAN
Middle Name:
Last Name:JOSHI
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 1:9002 COPPERGATE RD
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-7560
Mailing Address - Country:US
Mailing Address - Phone:187-243-2777
Mailing Address - Fax:
Practice Address - Street 1:9002 COPPERGATE RD
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-7560
Practice Address - Country:US
Practice Address - Phone:187-243-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD453823208100000X
IAMD-41582208100000X
VA0101243827208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation