Individual provider · Type 1 NPI
Jonathan Bautista Tanawan, MD
Addiction Medicine (Family Medicine) Physician · Chicago, IL
NPI number
1609443571
Active
Practice location
1969 W Ogden Ave
Chicago, IL 60612-3765
Fax (312) 491-5020
Mailing address
1431 N Western Ave Ste 406
Chicago, IL 60622-1774
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.170234 (IL) |
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | 036.170234 (IL) |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
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About NPI 1609443571
Jonathan Bautista Tanawan, MD's National Provider Identifier is 1609443571, issued on Jun 8, 2021. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Chicago, IL. The record was last updated on Aug 26, 2025.