Tanquilut, Eugene M

Tanquilut, Eugene M is an individual health care provider with primary practice located at 20060 Governors Dr Suite 102, Olympia Fields IL 60461-1029. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Tanquilut, Eugene M can be contacted via phone (815) 824-4406.

Contact Information

Primary practice address
20060 Governors Dr Suite 102 Olympia Fields IL 60461-1029
Phone: (815) 824-4406
Fax: (815) 844-0307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 02002492A Indiana
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036094341 Illinois

Profile Details

NPI number 1043215148
LBN Legal business name Tanquilut, Eugene M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Mar 3rd, 2015 - about 9 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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Identifiers

StateTypeNumberIssuer
All States NPI 1043215148 NPPES
Illinois MEDICAID 036094341

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