Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 125068734 | IL |
NPI | 1073066379 |
---|---|
Provider Name | Alexandre Darani |
First Address | Chicago, IL 60611-4323 |
Second Address | Chicago, IL 60611-2927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2016 |
Last Update Date | 03/08/2016 |