Shiraz P. Tata

LBN: Shiraz Tata Phd Llc
Shiraz P. Tata is an health care organization with primary practice located at 6072 Brynwood Dr Ste 107 , Rockford IL 61114. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Shiraz Tata Phd Llc can be contacted via phone (815) 519-2949, or through Tata, Shiraz P via phone (815) 519-2949.

Contact Information

Primary practice address
6072 Brynwood Dr Ste 107 Rockford IL 61114
Phone: (815) 519-2949
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tata, Shiraz P PH D
Phone: (815) 519-2949

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071.04963 Illinois

Profile Details

NPI number 1083109524
LBN Legal business name Shiraz Tata Phd Llc
DBA Doing business as Shiraz P. Tata
Authorized official Tata, Shiraz P PH D
Entity Organization
Organization subpart 1 No
Enumeration date Jun 27th, 2018
Last updated Aug 1st, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083109524 NPPES
Other 819809569 BCBSIL
Other 11740000 BCBSIL

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