Basic Information
| Provider Information | |||||||||
| NPI: | 1932316320 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TASHIMA | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 W HIGGINS RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601953203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472854200 | ||||||||
| FaxNumber: | 8478850130 | ||||||||
| Practice Location | |||||||||
| Address1: | 929 W HIGGINS RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601953203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472854200 | ||||||||
| FaxNumber: | 8478850130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 07/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 036-123746 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | A103573 | CA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081H0002X | 35.089617 | OH | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 036123746 | 05 | IL | MEDICAID | P00775562 | 01 | IL | MEDICARE RAILROAD CARRIER | OTHER |