Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 036054234 | IL |
NPI | 1871544932 |
---|---|
Provider Name | Ameeta K Bamzai |
First Address | Naperville, IL 60540 |
Second Address | Naperville, IL 60540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 24/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036054234 | (05) | IL |
C42709 | (02) |