Individual
ALI DAVID TABATABAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
28162354A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
209004917
IL
Other
Enumeration date
05/11/2006
Last updated
05/04/2021
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