Individual
MARIA TERESA TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2845 N SHERIDAN RD, STE 902, CHICAGO, IL 60657-7227
(773) 904-8641
(872) 888-1206
Mailing address
2845 N SHERIDAN RD, SUITE 902, CHICAGO, IL 60657-7227
(773) 904-8641
(872) 888-1206
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036093565
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093565
—
IL
01
—
1620171
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/28/2006
Last updated
08/24/2020
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