Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 45920 | WI |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 01081191A | IN |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 45920 | WI |
NPI | 1003093824 |
---|---|
Provider Name | Andleeb S Bangash |
First Address | Elmhurst, IL 60126-5204 |
Second Address | La Porte, IN 46350-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 14/09/2020 |