Provider Demographics
NPI:1013564111
Name:TABANI, AYMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:
Last Name:TABANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 OLD ORCHARD RD APT 308
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1022
Mailing Address - Country:US
Mailing Address - Phone:224-800-4275
Mailing Address - Fax:
Practice Address - Street 1:360 S WAUKEGAN RD STE A
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5654
Practice Address - Country:US
Practice Address - Phone:847-412-0311
Practice Address - Fax:847-412-0316
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011367152W00000X
WI3581-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist