Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036143155 | IL |
NPI | 1023261138 |
---|---|
Provider Name | Adam Mendel Sonabend Worthalter |
First Address | New York, NY 10025-9700 |
Second Address | Chicago, IL 60611-5970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 17/03/2018 |