Individual
SHAZIA TAYYAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD . MD
Contact information
Practice address
31480 N US HIGHWAY 45, LIBERTYVILLE, IL 60048-9444
(847) 680-2715
(847) 680-3832
Mailing address
31480 N US HIGHWAY 45, LIBERTYVILLE, IL 60048-9444
(847) 680-2715
(847) 680-3832
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036109759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363300648
TAX ID
IL
Enumeration date
09/01/2006
Last updated
07/08/2007
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