Provider Demographics
NPI:1841947371
Name:RIZVI TIERNAN PODIATRY PC
Entity type:Organization
Organization Name:RIZVI TIERNAN PODIATRY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-202-0319
Mailing Address - Street 1:1605 PEYTON TER
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-1220
Mailing Address - Country:US
Mailing Address - Phone:630-202-0319
Mailing Address - Fax:
Practice Address - Street 1:3675 DARLENE CT STE B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6523
Practice Address - Country:US
Practice Address - Phone:630-415-0056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty