Provider Demographics
NPI:1174972020
Name:TARIQ, SEHRISH
Entity type:Individual
Prefix:
First Name:SEHRISH
Middle Name:
Last Name:TARIQ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 MC DOWELL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6507
Mailing Address - Country:US
Mailing Address - Phone:630-849-9697
Mailing Address - Fax:630-689-1023
Practice Address - Street 1:1952 MC DOWELL RD STE 305
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6507
Practice Address - Country:US
Practice Address - Phone:630-689-1022
Practice Address - Fax:630-689-1023
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009887103TC0700X, 103TC0700X
IL071.009887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty