Tan, Tisha Joerla Mirasol
Tan, Tisha Joerla Mirasol is an individual health care provider with primary practice located at 442 N Il Route 31 , Crystal Lake IL 60012-3709. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Tan, Tisha Joerla Mirasol can be contacted via phone (224) 238-3211.Contact Information
Primary practice address
442 N Il Route 31
Crystal Lake IL 60012-3709
Phone: (224) 238-3211
Fax: (224) 535-8215
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 036137011 | Illinois |
Profile Details
| NPI number | 1881959872 |
|---|---|
| LBN Legal business name | Tan, Tisha Joerla Mirasol |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2012 |
| Last updated | Sep 15th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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