Ibrahim A Taha, DPM | |
1221 N Highland Ave, Aurora, IL 60506-1404 | |
(630) 859-8700 | |
Not Available |
Full Name | Ibrahim A Taha |
---|---|
Gender | Male |
Speciality | Podiatrist |
Location | 1221 N Highland Ave, Aurora, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487763678 | NPI | - | NPPES |
016005184 | Medicaid | IL | |
04515143 | Other | IL | BCBS# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 016-005184 (Illinois) | Primary |
Provider Name | Advocate Health And Hospitals Corporation |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1003542184 PECOS PAC ID: 7810800935 Enrollment ID: O20220930002728 |
Mailing Address | Practice Location Address |
---|---|
Ibrahim A Taha, DPM 2357 Sequoia Dr, Aurora, IL 60506-6222 Ph: (630) 859-6800 | Ibrahim A Taha, DPM 1221 N Highland Ave, Aurora, IL 60506-1404 Ph: (630) 859-8700 |
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