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Individual

DR. NARAYAN S TATA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1999 SPRINGBROOK SQUARE DR STE 101, NAPERVILLE, IL 60564-5946
(630) 378-4590
(630) 378-4592
Mailing address
PO BOX 9531, NAPERVILLE, IL 60567-0531
(630) 378-4590
(630) 378-4592

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036107147
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036107147
STATE MEDICAL LICENSE
IL
Enumeration date
05/21/2006
Last updated
12/19/2012
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