Individual
DR. JASON J TANGUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
333 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1748
(708) 709-6396
(708) 709-6112
Mailing address
333 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1748
(708) 709-6396
(708) 709-6112
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4673170001
DMERC GROUP
IL
01
—
P00448603/CK6882
RAILROAD MEDICARE
IL
Enumeration date
01/14/2008
Last updated
03/17/2008
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