Individual
MUSADDIQ TARIQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 783-2226
Mailing address
504 CLINTON CENTER DRIVE, CBO-SUITE 4300, CLINTON, MS 39056-5610
(601) 815-2005
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036.161479
IL
2084P0800X
Psychiatry Physician
25MA10658500
NJ
2084P0800X
Psychiatry Physician
76824
WI
Other
Enumeration date
03/26/2014
Last updated
10/16/2023
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