Individual ProviderThana TarshaObstetrics & GynecologyAllopathic & Osteopathic PhysiciansPractice Address2222 West Division, Chicago, IL 60622(773) 509-9099(773) 227-0111PECOS EnrollmentBased on the most recent information from CMS, provider Thana Tarsha is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1063432375Provider TypeIndividualFull NameTarsha, ThanaTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date7/20/2006Last Updated3/24/2021Contact InformationPractice LocationPractice Address2222 West Division, Chicago, IL 60622Phone(773) 509-9099Fax(773) 509-9006Mailing LocationMailing Address2222 West Division Suite 330, Chicago, IL 60622Phone(773) 227-0111Fax(773) 227-0006Provider TaxonomiesCodeDescriptionLicenseCode207V00000XPrimaryDescriptionObstetrics & GynecologyAllopathic & Osteopathic PhysiciansLicense036076266IllinoisProvider IdentifiersIDDescriptionIssuerID036076266DescriptionMedicaidIssuerUnlistedIllinois