Individual
HIRA TARIQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1400
(815) 490-1881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.157745
IL
207Q00000X
Family Medicine Physician
036157745
IL
207Q00000X
Family Medicine Physician
12507304
IL
207Q00000X
Family Medicine Physician
125073304
IL
Other
Enumeration date
06/25/2018
Last updated
08/04/2021
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