Tejal R. Modi in Evanston - Physician Assistant
Tejal R. Modi - NPI 1639370794
Tejal R. Modi is a Physician Assistant in Evanston, Illinois. Tejal R. Modi practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Tejal R. Modi is 1639370794. The last update date is 2016-06-13.
Tejal R. Modi's current location address is 2650 Ridge Ave, Evanston, Illinois. You can contact this provider via phone number 8475702111. The mailing address for Tejal R. Modi is 2650 Ridge Ave, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tejal R. Modi |
|---|---|
| Address | 2650 Ridge Ave, Evanston, Illinois |
| Phone Number | 8475702111 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1639370794 |
|---|---|
| Provider Enumeration Date | 2007-05-29 |
| Last Updated Date | 2016-06-13 |
Provider Mailing Address Detail
| Address | 2650 Ridge Ave |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 602011718 |
| Phone Number | 8475702111 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
|
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 085-002793 | IL | IL STATE LIC |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Tejal R. Modi by the Centers for Medicare & Medicaid Services?
The Tejal R. Modi has been issued the NPI (National Provider Identifier) 1639370794, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Tejal R. Modi?
The Tejal R. Modi is situated at 2650 Ridge Ave, in the city of Evanston, state of IL, with the zip code 602011718.
What is the Tejal R. Modi's area of specialization and corresponding taxonomy classification?
The Tejal R. Modi's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
On what date did the Tejal R. Modi receive its 1639370794 assignment from the Centers for Medicare & Medicaid Services?
The Tejal R. Modi was assigned its 1639370794 by the Centers for Medicare & Medicaid Services on 2007-05-29.
When was the information pertaining to Tejal R. Modi most recently updated or revised?
The details related to Tejal R. Modi, including its address, specialty, and other relevant information, were last updated or revised on 2016-06-13.
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