Provider Demographics
NPI:1356397210
Name:SHEIKH, M TAHIR (MD)
Entity type:Individual
Prefix:DR
First Name:M
Middle Name:TAHIR
Last Name:SHEIKH
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 1:1341 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3401
Mailing Address - Country:US
Mailing Address - Phone:630-719-5454
Mailing Address - Fax:630-719-1263
Practice Address - Street 1:7234 OGDEN AVE
Practice Address - Street 2:SUITE 3N
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-2269
Practice Address - Country:US
Practice Address - Phone:708-447-2277
Practice Address - Fax:708-447-2274
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360506452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036050645Medicaid
ILD12786Medicare UPIN
IL036050645Medicaid