Daryll Hannah Amid Tahiyam
Nurse Practitioner, Adult Health in Chicago, IL. Individual provider (NPI-1).
NPI number1316705239
StatusActive
Last updated in NPPESMar 6, 2024
Details
- NPI
- 1316705239
- Entity type
- Individual (NPI-1)
- Name
- Daryll Hannah Amid Tahiyam
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 6, 2024
- Certification date
- Mar 6, 2024
- Last updated
- Mar 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | 209029302 | IL | Yes |
Practice location
5841 S Maryland Ave Rm 4602Chicago, IL 60637-1443
Phone 773-702-6222 · Fax 773-702-9076
Mailing address
1124 Camellia Dr Apt 3Munster, IN 46321-3620
Phone 773-968-3355
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