Provider Demographics
NPI:1649659053
Name:AZAM, TARIQ U (MD)
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:U
Last Name:AZAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2151 WAUKEGAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1885
Mailing Address - Country:US
Mailing Address - Phone:847-444-5300
Mailing Address - Fax:847-267-1429
Practice Address - Street 1:2151 WAUKEGAN RD STE 100
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1885
Practice Address - Country:US
Practice Address - Phone:847-444-5300
Practice Address - Fax:847-267-1429
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2022-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036160053207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease