Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 036-106576 | IL |
NPI | 1063466597 |
---|---|
Provider Name | Anand Vora |
First Address | Des Plaines, IL 60016-2359 |
Second Address | Libertyville, IL 60048-3757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 28/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I14681 | (02) |