Individual
DR. NICHOLAS J TAPAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 FOXFIELD RD, #203, ST CHARLES, IL 60174-5799
(630) 797-4255
(630) 797-4259
Mailing address
2900 FOXFIELD RD, #203, ST CHARLES, IL 60174-5799
(630) 797-4255
(630) 797-4259
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036093506
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS
IL
01
—
1033149844
CDPG GROUP NPI
IL
01
—
1730144171
NPI
IL
01
—
363149833
CDPG TAX IDENTIFICATION NUMBER
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
920540003
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
04/19/2006
Last updated
04/15/2013
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