Provider Demographics
NPI:1831199827
Name:TAM, DAVID YI (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YI
Last Name:TAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4742
Mailing Address - Country:US
Mailing Address - Phone:630-932-8308
Mailing Address - Fax:630-932-8308
Practice Address - Street 1:733 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4742
Practice Address - Country:US
Practice Address - Phone:630-932-8308
Practice Address - Fax:630-932-8308
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2226120OtherBCBS OF IL.