Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 125070927 | IL |
Y | 208600000X | Surgeon | 125070927 | IL |
NPI | 1003345588 |
---|---|
Provider Name | Adam Lam |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637-1447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 08/06/2017 |