Provider Demographics
NPI:1902879778
Name:ISAKOVA, TAMARA (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:
Last Name:ISAKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 N SAINT CLAIR ST
Mailing Address - Street 2:18TH FLOOR ROOM 18-083
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3234
Mailing Address - Country:US
Mailing Address - Phone:312-503-6921
Mailing Address - Fax:312-503-5656
Practice Address - Street 1:633 N SAINT CLAIR ST
Practice Address - Street 2:18TH FLOOR ROOM 18-083
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3234
Practice Address - Country:US
Practice Address - Phone:312-503-6921
Practice Address - Fax:312-503-5656
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL107174207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology