Individual
DR. ALBERT C TANLIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
845 S 4TH ST, ROBERTS CLINIC LTD, WATSEKA, IL 60970-1628
(815) 432-2461
(815) 432-2535
Mailing address
819 W LAFAYETTE ST, #93, WATSEKA, IL 60970
(815) 432-4743
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
036091262
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091262
—
IL
01
—
03815080
BC BS
IL
05
—
200386800A
—
IN
05
—
3711693620021
—
IL
01
—
K10959
PIN
—
Enumeration date
01/28/2006
Last updated
04/11/2013
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