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Individual

TAHJI RASHAAD DIXON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
178 N HUMPHREY AVE APT 1, OAK PARK, IL 60302-2577
(708) 539-2701
Mailing address
178 N HUMPHREY AVE APT 1, OAK PARK, IL 60302-2577
(708) 539-2701

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041441760
IL
367500000X
Certified Registered Nurse Anesthetist
041441760
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209030681
IL

Other

Enumeration date
08/26/2022
Last updated
01/16/2025
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