Basic Information
| Provider Information | |||||||||
| NPI: | 1316398936 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TARABICHI | ||||||||
| FirstName: | ULA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 E CARPENTER ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627691000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175446464 | ||||||||
| FaxNumber: | 2177576805 | ||||||||
| Practice Location | |||||||||
| Address1: | 11600 S. KEDZIE, SUITE D | ||||||||
| Address2: | |||||||||
| City: | MERRIONETTE PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086846867 | ||||||||
| FaxNumber: | 7086846869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2016 | ||||||||
| LastUpdateDate: | 04/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036149713 | IL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RE0101X | 036.149713 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.