Individual
ISAAC TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(217) 521-3074
Mailing address
1110 N INSTITUTE PL, PEORIA, IL 61606-1019
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036149687
IL
390200000X
Student in an Organized Health Care Education/Training Program
125069233
IL
Other
Enumeration date
06/10/2016
Last updated
12/26/2024
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