Individual
DR. TAE'NI CHANG-STROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1160 JOLIET ST, STE 103, DYER, IN 46311-1925
(219) 322-8534
(219) 865-9072
Mailing address
1160 JOLIET ST, STE 103, DYER, IN 46311-1925
(219) 322-8534
(219) 865-9072
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01042969
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365599
ANTHEM PROVIDER ID
IN
05
—
100463430B
—
IN
01
—
10780906
CAQH
—
01
—
90001231
BCBSIL PROVIDER ID
IL
Enumeration date
05/27/2005
Last updated
04/30/2015
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