Individual
DARYLL HANNAH AMID TAHIYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5841 S MARYLAND AVE RM 4602, CHICAGO, IL 60637-1443
(773) 702-6222
(773) 702-9076
Mailing address
1124 CAMELLIA DR APT 3, MUNSTER, IN 46321-3620
(773) 968-3355
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209029302
IL
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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