Individual
DR. TARUN MULLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
485 S DOBSON RD STE 101, CHANDLER, AZ 85224-5603
(480) 728-4981
Mailing address
2631 WILLIAMSBURG AVE, SUITE 301, GENEVA, IL 60134-1101
(630) 232-2025
(630) 232-2780
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036108726
IL
207RG0100X
Gastroenterology Physician
35.143072
OH
207RG0100X
Gastroenterology Physician
4301502257
MI
207RG0100X
Gastroenterology Physician
Primary
58745
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108726
—
IL
01
—
04532244
BLUE CROSS BLUE SHIELD
IL
01
—
P00197568
RAILROAD MEDICARE
IL
Enumeration date
07/18/2005
Last updated
08/08/2023
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