Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036086823 | IL |
N | 207YS0123X | Facial Plastic Surgeon | 036086823 | IL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 036086823 | IL |
NPI | 1639170731 |
---|---|
Provider Name | Ajay K. Chauhan |
First Address | Phoenix, AZ 85082-4568 |
Second Address | Hoffman Estates, IL 60169-1064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F96673 | (02) | IL |