Basic Information
| Provider Information | |||||||||
| NPI: | 1780330696 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AASHISH TANEJA MDSC | ||||||||
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| OtherOrganizationName: | AASHISH TANEJA MD | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 332 S MICHIGAN AVE STE 121T2 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606044434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557546900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 BIESTERFIELD RD STE 3007 | ||||||||
| Address2: | |||||||||
| City: | ELK GROVE VILLAGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600073371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472906513 | ||||||||
| FaxNumber: | 8472908505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2022 | ||||||||
| LastUpdateDate: | 06/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | SCHANCK | ||||||||
| AuthorizedOfficialFirstName: | MAGDALENA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7089414688 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.