Gubatanga, Taj
Gubatanga, Taj is an sole proprietor health care provider with primary practice located at 2160 S 1St Ave , Maywood IL 60153-3328. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Gubatanga, Taj can be contacted via phone (312) 774-6297.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 209024958 | Illinois |
| Nursing Service Providers / Registered Nurse | 163W00000X | 28206360A | Indiana |
Profile Details
| NPI number | 1629747282 |
|---|---|
| LBN Legal business name | Gubatanga, Taj |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 8th, 2021 |
| Last updated | May 31st, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629747282 | NPPES |
| Other | 1229 | BIRTHDATE |
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