Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036113859 | IL |
N | 2080P0201X | Pediatric Allergist | 036113859 | IL |
NPI | 1699978791 |
---|---|
Provider Name | Amishi S Murthy |
First Address | Evanston, IL 60201-2455 |
Second Address | Evanston, IL 60201-2455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 25/07/2012 |