Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 36040493 | IL |
NPI | 1063479202 |
---|---|
Provider Name | Alan Melvin Rogin |
First Address | Chicago, IL 60625-3657 |
Second Address | Chicago, IL 60625-3657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 29/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036040493 | (05) | IL |
C38143 | (02) |