Individual
DR. EUGENE M TANQUILUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20060 GOVERNORS DR, SUITE 102, OLYMPIA FIELDS, IL 60461-1029
(815) 824-4406
(815) 844-0307
Mailing address
20060 GOVERNORS DR, SUITE 102, OLYMPIA FIELDS, IL 60461-1029
(815) 824-4406
(815) 844-0307
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
02002492A
IN
2086S0129X
Vascular Surgery Physician
Primary
036094341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094341
—
IL
Enumeration date
06/15/2005
Last updated
03/03/2015
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