Organization
RIVERSIDE ORTHOPEDICS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARIQ BIN IFTIKHAR MD (ORTHOPEDIC SURGEON)
(708) 484-9480
Entity
Organization
Contact information
Practice address
6641 WEST OGDEN AVENUE, BERWYN, IL 60402-3756
(708) 484-9480
(708) 484-9482
Mailing address
6641 WEST OGDEN AVENUE, BERWYN, IL 60402-3756
(708) 484-9480
(708) 484-9482
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
036047917
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006895400
FEDERAL BLACK LUNG PROGRA
IL
01
—
01633335
BCBS
IL
05
—
036047917
—
IL
01
—
1343149
FIRST HEALTH NETWORK
IL
01
—
154664
UNITEDHEALTHCARE
IL
01
—
202841400
ACS/OWCP
IL
01
—
2072539
CIGNA
IL
01
—
3181386
AETNA
IL
01
—
320541514
TRICARE
IL
01
—
AS62001780001
CIGNA
IL
01
—
P00064487
RAILROAD MEDICARE
IL
Enumeration date
08/19/2006
Last updated
08/26/2008
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