Provider Demographics
NPI:1588378327
Name:TIJORIWALA, RADHIKA CHINTAN
Entity type:Individual
Prefix:
First Name:RADHIKA
Middle Name:CHINTAN
Last Name:TIJORIWALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N ROSELLE RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1850
Mailing Address - Country:US
Mailing Address - Phone:224-228-8349
Mailing Address - Fax:
Practice Address - Street 1:890 N ROSELLE RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1850
Practice Address - Country:US
Practice Address - Phone:224-228-8349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.034041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist