Provider Demographics
NPI:1891135471
Name:TAHIR, RIZWAN (MD)
Entity type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:
Last Name:TAHIR
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 1:175 N HARBOR DR APT 3607
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7883
Mailing Address - Country:US
Mailing Address - Phone:248-763-0698
Mailing Address - Fax:
Practice Address - Street 1:912 S WOOD ST STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7203
Practice Address - Country:US
Practice Address - Phone:312-996-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301103684207T00000X
IL036.157354207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery